To observe the effect of autologous platelet-rich plasma (PRP) combined with Meek microskin grafts in repairing wounds of extremities in severe burn patients, and to explore its possible mechanism. The prospective controlled research method was used. From September 2016 to January 2020, 16 patients aged 18-69, with extensive deep burns who met the selection criteria, including 9 males and 7 females, were admitted to the Department of Burns and Plastic Surgery of the 909th Hospital of the Joint Logistic Support Force of PLA. The bilateral limbs with similar injury in 8 patients were divided into Meek skin grafting+PRP group and PRP alone group according to the random number table method; the limbs with severer injury were included into Meek skin grafting+PRP group, and the limbs on the other side were included into Meek skin grafting alone group in the other 8 patients. The wounds of extremities in patients of Meek skin grafting+PRP group were repaired with autologous PRP and Meek microskin grafts, and the wounds of extremities in patients of Meek skin grafting alone group were repaired with Meek microskin grafts alone. On post surgery day (PSD) 10, the survival and fusion of Meek microskin grafts were observed and the survival rate and fusion rate were calculated; the morphology of the Meek microskin graft base was observed by hematoxylin-eosin staining, the angiogenesis of the Meek microskin graft base was observed by immunohistochemical staining, and the microvessel was counted. Data were statistically analyzed with paired sample test. On PSD 10, the wounds of extremities in patients of Meek microskin grafting+PRP group were dry, and most of the transplanted skin grafts were closely adhered to the basal tissue; while a small amount of exudate could be found in the wounds of extremities in patients of Meek skin grafting alone group, and a small part of the transplanted skin micrografts fell off or poorly attached to the basal tissue. The survival rate and the fusion rate of Meek microskin grafts in wounds of extremities in patients of Meek skin grafting+PRP group were (93.6±3.3)% and (83.3±3.2)%, which was higher than (88.5±3.5)% and (80.1±2.8)% of Meek skin grafting alone group, respectively (=3.650, 2.999, <0.01). On PSD 10, the basal epidermis was closely connected with dermis of Meek microskin grafts in wounds of extremities in patients of Meek skin grafting+PRP group, with much inflammatory cell infiltration and active microvascular hyperplasia, while the basal epidermis was less closely connected with dermis of Meek microskin grafts in wounds of extremities in patients of Meek skin grafting alone group, with obvious degeneration of collagen fibers under the dermis, less inflammatory cell infiltration, and slightly poor microvascular hyperplasia. On PSD 10, the microvessels in basal tissue of Meek microskin grafts in wounds of extremities in patients of Meek skin grafting+PRP group were densely distributed in clusters, while those in Meek skin grafting alone group were in scattered and punctate distribution. On PSD 10, the microvessels number in basal tissue of Meek microskin grafts in wounds of extremities in patients of Meek skin grafting+PRP group was (35.6±5.6), which was significantly more than (29.2±6.9) of Meek skin grafting alone group (=2.671, =0.017). Autologous PRP can effectively promote the survival rate and fusion rate of Meek microskin grafts in wounds after escharectomy in severe burn patients by promoting angiogenesis in Meek microskin grafts base.

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