Effect of Autologous Platelet-Rich Plasma on Thyroidectomy Scars: A Prospective Interventional Study in a Tertiary...

Introduction Thyroid disorders are highly prevalent in India, and thyroidectomy is a frequently performed surgical procedure to manage these conditions. While conventional thyroidectomy is effective, it often results in visible neck scars, leading to patient dissatisfaction and psychosocial concerns. Platelet-rich plasma (PRP), rich in growth factors and adhesion molecules, has shown promise in enhancing wound healing and modulating scar formation. However, its efficacy in improving thyroidectomy scars remains underexplored, particularly in the Indian context. Methods A prospective, randomized, interventional study was conducted over 18 months (April 2023- October 2024) at the Department of Otorhinolaryngology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. Thirty-two patients (aged 18-50 years) undergoing conventional thyroidectomy were randomized into two groups: Group A (control, n = 16) received standard subcuticular sutures, while Group B (intervention, n = 16) received intraoperative autologous PRP injections prior to closure. PRP was prepared by centrifuging 10 mL of the patient's blood at 2500 rpm for 10 minutes. Scar assessment was performed at 4 months postoperatively using the Patient and Observer Scar Assessment Scale (POSAS) by blinded evaluators. Results Baseline characteristics, including age, sex distribution, diagnosis, and type of thyroidectomy, were comparable between groups. Patient-reported outcomes indicated significantly less scar pain (mean score: 1.06 vs. 1.75; p = 0.002), reduced pigmentation difference (1.81 vs. 2.31; p = 0.032), and decreased scar thickness (1.75 vs. 2.12; p = 0.033) in the PRP group. The total POSAS patient score was significantly lower in Group B (8.81 vs. 10.56; p = 0.012), reflecting better subjective scar perception. Observer assessments corroborated these findings, noting reduced vascularity (1.06 vs. 2.31; p = 0.001), improved pigmentation (1.81 vs. 2.43; p = 0.031), and enhanced pliability (1.43 vs. 1.87; p = 0.021) in the PRP group. The total POSAS observer score favored Group B (9.12 vs. 12.18; p = 0.003). Conclusion Intraoperative application of autologous PRP significantly enhances scar quality following thyroidectomy, as evidenced by both patient and observer assessments. PRP offers a cost-effective, safe, and autologous approach to improve postoperative cosmetic outcomes, particularly beneficial in resource-limited settings. Further studies with larger cohorts and extended follow-up are warranted to validate these findings and establish standardized protocols for PRP application in thyroid surgery.