Use of Platelet-Activated Plasma in the Treatment of Deep Burns in the Elderly, Senile and Long-Living Patients

Introduction. The study of the data obtained by related specialists allowed assuming about the perspectives of using platelet-activated plasma in the treatment of burns in geriatric patients. The influence of growth factors contained in platelets, which are responsible for tissue regeneration, determines the course of processes such as proliferation, differentiation and angiogenesis. This effect has the potential to partially offset the deficit in the body’s regenerative capabilities observed due to age-related involution.

The aim of the study was to improve clinical outcomes in the elderly and senile patients with deep burns through the use of platelet-activated plasma at the stage of preparation for skin grafting.

Materials and methods. The study included data obtained during the treatment of 124 patients 60 years of age and older with third-degree burns (ICD-X) and was performed in the Department of Thermal Injuries of the Research Institute of Emergency Medicine named after. I.I. Dzhanelidze. Patients were randomized into the study after assessing inclusion and non-inclusion criteria. The patients included in the study were divided into 2 groups. During dressings after performing staged necrectomy on segments with wound bottom represented by conditionally viable tissue structures, patients of the main group (65 victims) were applied platelet-activated plasma, this followed by preparation of granulating wounds to accept plastic material.. In patients of the control group (59 patients), preparation of granulating wounds for plastic surgery was intensified by the applied antibacterial ointment “Levomekol”.

The study groups did not differ significantly in gender, age, total area of damage, prevalence of deep burns, or thermal injury severity index.

When assessing the results, a complex of clinical, laboratory, and instrumental methods was used. The results obtained were processed using SPSS23 and Microsoft Office Excel 10.

Results. It has been found that the problems of treating deep burns in the elderly, senile patients and long-livers are associated with the comorbidity of victims in the category, as well as their delayed visit for medical assistance at the specialized medical care facilities, the fact complicating the implementation of early surgical treatment principles. The use of platelet-activated plasma during conservative preparation of deep wounds for plastic closure in this group of burnt patients allows for a reduced area of the burn wound on average, by 16%, by the time of autodermoplasty, which is 2 times higher than the same parameter in the control group. The potential of platelet-activated plasma use is realised in its multiple application, as the skin defect is cleared of necrotic elements, the fact providing a reduced time of burn wound preparation for plastic surgery in patients of the main group by 6 days on average.

Conclusion. The use of platelet-activated plasma during the conservative deep wound preparation for plastic closure allows for a reduced area of the burn wound at the time of autodermoplasty by 16%, on average, which is 2 times higher than the same value in the control group, and a reduced time required to prepare burn wounds for plastic surgery in patients of the main group for 6 days, on average.