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David B. Hom, MD; Bradley M. Linzie, MD; Trevor C. Huang, PhD

Arch Facial Plast Surg. 2007;9(3):174-183.

Objective  To compare the healing of full-thickness skin punch wounds treated with topical autologous platelet gel (APG) vs conventional therapy (antibiotic ointment and/or occlusive dressings) in healthy volunteers.

Methods  A prospective, single-blind, pilot study comprising 80 full-thickness skin punch wounds (4 mm diameter) was conducted on the thighs of 8 healthy volunteers. With each subject serving as his or her own control (5 punch sites per leg), APG was applied topically on one thigh, and an antibiotic ointment and/or a semiocclusive dressing was applied on the other thigh. Healing was monitored for spontaneous wound closure by clinical assessment and by digital photographs over 6 months. Over 35 days, 64 serial dermal biopsy specimens (6 mm diameter) were analyzed (using hematoxylin-eosin, Mason trichrome, CD-34, and Ki-67 stains) to measure differences between treated and control sites for cellularity, granulation formation, vascularity, epithelialization, and cellular replication.

Results  Over a 42-day period, the APG-treated sites had statistically increased wound closure compared with controls by visual clinical assessment and by digital planimetry photographic measurements (P.02). On day 17, the percentage of closure was 81.1% ± 2.5% (mean ± SE) for the APG-treated sites and 57.2% ± 5.9% for the control sites. Also, the APG wound closure velocities were significantly faster than those of the controls (P = .001). Histologically, over time, the APG-treated sites had similar cellularity, cellular replication, granulation tissue, vascularity, and epithelialization compared with controls. However, when the platelet count in the gel was more than 6 times the baseline intravascular platelet count in some subjects, epithelialization and granulation formation appeared 3 days earlier in the APG-treated group. Furthermore, in vitro testing of supplemental APG showed increased endothelial cell proliferation compared with controls (P<.04).

Conclusion  This pilot study provides preliminary evidence that topical APG may hasten wound closure in full-thickness dermal wounds in healthy individuals.

Trial Registration  clinicaltrials.gov Identifier: NCT00199992

Author Affiliations: Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of Minnesota School of Medicine and Hennepin County Medical Center (Dr Hom), Department of Pathology, Hennepin County Medical Center (Dr Linzie), and Medtronic Inc (Dr Huang), Minneapolis, Minn. Dr Hom is now with the Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio.

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