Combination Treatment for Full Thickness Wounds: Platelet-Rich-Gels and Electro-Spun Collagen Scaffolds
Full thickness wounds encompass damage through the epidermis and dermis with characteristic loss of structure and healing through secondary intention. Two treatments that have been thoroughly researched and shown efficacy in treating these types of wounds are platelet-rich-gels (PRG) and electro-spun collagen scaffolds. However, little research has been done to investigate the two as a combination treatment, a biomaterial enrich platelet-rich-gel. PRGs provide the wound with growth factors and cytokines that are naturally present in a wound bed, but in a concentration above that of native physiological conditions. The electro-spun collagen scaffold works on two premises, the first is that it is providing a vital skin protein that will be deposited during the wound healing process in addition to providing a matrix for cells to migrate into. The investigation into PRGs and the combination treatment was ultimately accomplished in a three step study: creation of a PRG from platelet-rich-plasma (PRP) utilizing calcium chloride; analysis into the effects of calcium chloride on platelets through scanning electron microscopy; and finally an in vivo study comparing two treatments, the combination treatment and standalone electrospun scaffold treatment, and a control (dressed with petroleum gauze). Calcium chloride revealed to be an effective method for gel creation. SEM analysis detailed whole blood platelets demonstrating normal discoid morphology found in quiescent platelets, whereas the PRG platelets demonstrated extending pseudopods and bleb formation indicative of activation. In the in vivo study, both the standalone electro-spun collagen scaffold treatment and the combination treatment had statistical significance 144 hours post wound creation when compared to the control with p values of 0.0092 and 0.0016 respectively. However, there was no statistical significance between the combination treatment and the standalone electro-spun scaffold treatment at any time point of the study.