To evaluate and analyze the effect of platelet-rich plasma (PRP) injection on the scar formed after unilateral complete cleft lip scar repair using a modified Millard technique.
Hypothesis:
An unavoidable cheiloplasty scar is a result of the wound healing process that not only influences patient self-esteem for life but also affects muscle function.
Design:
Blind, randomized, controlled clinical trial.
Patients:
From December 2016 to February 2018, 24 patients with unilateral complete cleft lip undergoing primary cheiloplasties were equally assigned to study and control groups.
Intervention:
All patients were treated by modified Millard cheiloplasty. In the study group, PRP was injected into the muscle and skin layers immediately after wound closure, while the control group patients were treated with no PRP injection.
Outcomes Measures:
Scar width was assessed after 6 months through the muscle using ultrasonography and at the skin surface via photographs.
Results:
Scar width showed a significant improvement in the study group.
Conclusions:
Injection of autologous PRP provides effective improvement of cutaneous and muscular wound healing and decreases scar tissue formation.
A HamidMSMohamed AliMRYusofAGeorgeJLeeLPC. Platelet-rich plasma injections for the treatment of hamstring injuries: a randomized controlled trial. Am J Sport Med. 2014;42(10):2410–2418.
2.
AndradeC-K. Outcome-Based Massage: Putting Evidence Into Practice. Philadelphia, PA: Lippincott Williams & Wilkins; 2013.
3.
AnituaEPradoRSánchezMOriveG. Platelet-rich plasma: preparation and formulation. Oper Tech Orthop. 2012;22(1):25–32.
4.
BambaceNMLevisJEHolmesCE. The effect of P2Y-mediated platelet activation on the release of VEGF and endostatin from platelets. Platelets. 2010;21(2):85–93.
5.
BorrionePGrassoLChiertoEGeunaSRaccaSAbbadessaGRonchiGFaiolaFDi GianfrancescoAPigozziF. Experimental model for the study of the effects of platelet-rich plasma on the early phases of muscle healing. Blood Transfus. 2014;12(suppl 1): s221.
6.
BuchwaldDKaltschmidtCHaardtHLaczkovicsAReberD. Autologous platelet gel fails to show beneficial effects on wound healing after saphenectomy in CABG patients. J Extra-Corpor Technol. 2008;40(3):196.
7.
ChangC-SWallaceCGHsiaoY-CChangC-JChenPK-T. Botulinum toxin to improve results in cleft lip repair: a double-blinded, randomized, vehicle-controlled clinical trial. PLoS One. 2014;9(12):e115690.
8.
ChangC-SWallaceCGHsiaoY-CWallaceCGHsiaoYCHuangJJChenZCChangCJLoLJChenPK, et al.Clinical evaluation of silicone gel in the treatment of cleft lip scars. Sci Rep. 2018;8(1):7422.
9.
ChoiB-HZhuS-JKimB-YHuhJ-YLeeS-HJungJ-H. Effect of platelet-rich plasma (PRP) concentration on the viability and proliferation of alveolar bone cells: an in vitro study. Int J Oral Maxillofac Surg. 2005;34(4):420–424.
10.
Cieslik-BieleckaAGazdzikTSBieleckiTMCieslikT. Why the platelet-rich gel has antimicrobial activity?Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;3(103):303–305.
11.
ClarkR. Cutaneous wound healing. N Engl J Med. 1999;341(10):738–746.
12.
DimauroIGrassoLFittipaldiSFantiniCMercatelliNRaccaSGeunaSDi GianfrancescoACaporossiDPigozziF, et al.Platelet-rich plasma and skeletal muscle healing: a molecular analysis of the early phases of the regeneration process in an experimental animal model. PLoS One. 2014;9(7):e102993.
13.
DixonMJMarazitaMLBeatyTHMurrayJC. Cleft lip and palate: understanding genetic and environmental influences. Nat Rev Genet. 2011;12(3):167.
14.
EbyBW. Platelet-rich plasma: harvesting with a single-spin centrifuge. J Oral Implantol. 2002;28(6):297–301.
15.
FortierLASmithRK. Regenerative medicine for tendinous and ligamentous injuries of sport horses. Vet Clin North Am Equine Pract. 2008;24(1):191–201.
16.
GarcezTNAMelloHFMörschbacherPDTerracianoPBPignoneVCioatoMJCirne-LimaEOContesiniEA. Liquid and gel platelet rich plasma as skin healing adjuvant. Acta Sci Vet. 2016;44:1–7.
17.
HuntOBurdenDHepperPJohnstonC. The psychosocial effects of cleft lip and palate: a systematic review. Eur J Orthodont. 2005;27(3):274–285.
18.
JeeC-HEomN-YJangH-MJungHWChoiESWonJHHongIHKangBTJeongDWJungDI. Effect of autologous platelet-rich plasma application on cutaneous wound healing in dogs. J Vet Sci. 2016;17(1):79–87.
19.
KnightonDRCiresiKFFiegelVDAustinLLButlerEL. Classification and treatment of chronic nonhealing wounds. Successful treatment with autologous platelet-derived wound healing factors (PDWHF). Ann Surg. 1986;204(3):322.
20.
LiuJSaulDBökerKOErnstJLehmanWSchillingAF. Current methods for skeletal muscle tissue repair and regeneration. Biomed Res Int. 2018. doi:10.1155/2018/1984879.
21.
MarlovitsSMousaviMGäblerCErdösJVécseiV. A new simplified technique for producing platelet-rich plasma: a short technical note. In: MarekSWeiskopfRBGunzburgRAebiM, eds. Haemostasis in Spine Surgery. Berlin, Germany: Springer; 2005:108–112.
MarxRE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004;62(4):489–496.
25.
McAleerJPSharmaSKaplanEMPersichG. Use of autologous platelet concentrate in a nonhealing lower extremity wound. Adv Skin Wound Care. 2006;19(7):354–363.
26.
NagataMJMessoraMRFurlanetoFAFuciniSEBoscoAFGarciaVGDeliberadorTMde MeloLG. Effectiveness of two methods for preparation of autologous platelet-rich plasma: an experimental study in rabbits. Eur J Dent. 2010;4(4):395.
27.
NitaAOrzanOFilipescuMJianuD. Fat graft, laser CO2 and platelet-rich-plasma synergy in scars treatment. J Med Life. 2013;6(4):430.
28.
NuridinovichVU. Ultrasound examination of upper lip in patients with unilateral cheilognathopalatoschisis. Eur Sci Rev. 2015;(9-10):51–53.
29.
Raposo-AmaralCEGiancolliAPDenadaiRSomensiRSRaposo-AmaralCA. Late cutaneous lip height in unilateral incomplete cleft lip patients does not differ from the normative data. J Craniofac Surg. 2014;25(1):308–313.
30.
RaslanMMMiladNMAlAzizAA. Effect of autologous platelet-rich plasma in the promotion of healing of chronic ulcers. Int Surg J. 2017;5(1):15–19.
31.
RogersCRWeinbergSMSmithTDDeleyiannisFWMooneyMPMarazitaML. Anatomical basis for apparent subepithelial cleft lip: a histological and ultrasonographic survey of the orbicularis oris muscle. Cleft Palate-Craniofac J. 2008;45(5):518–524.
32.
SabithaSVeerabahuMVikramanB. Esthetic evaluation of the treated unilateral cleft lip using photographs and image analysis software: a retrospective study. J Maxillofac Oral Surg. 2011;10(3):225–229.
33.
SalyerKERozenSMGenecovERGenecovDG. Unilateral cleft lip—approach and technique. Semin Plast Surg. 2005;19(4):313–328.
34.
SanchezARSheridanPJKuppLI. Is platelet-rich plasma the perfect enhancement factor? A current review. Int J Oral Maxillofac Implants. 2003;18(1):93–103.
35.
TaylorDWPetreraMHendryMTheodoropoulosJS. A systematic review of the use of platelet-rich plasma in sports medicine as a new treatment for tendon and ligament injuries. Clin J Sport Med. 2011;21(4):344–352.
36.
van HeesNJThijssenJMHuyskensRWWeijersGNillesenMMde KorteCLKatsarosC. Quantitative ultrasound imaging of healthy and reconstructed cleft lip: a feasibility study. Cleft Palate-Craniofac J. 2007;44(3):261–268.
37.
YoungVLHutchisonJ. Insights into patient and clinician concerns about scar appearance: semiquantitative structured surveys. Plast Reconstr Surg. 2009;124(1):256–265.
