Use of Platelet-Rich Fibrin over Skin Wounds: Modified Secondary Intention Healing
A 30-year-old man who suffered a motorcycle accident, reported to the Department of Oral and Maxillofacial Surgery, presenting with an avulsive wound, approximately 0.5 × 1 cm in size, on the lower lip in the midline region with a disruption of the vermilion border and a white roll []. The depth of the wound was uneven with muscle tissue loss in some regions. The patient had no medical history. Primary closure could have caused pouting of the lip. Healing by secondary intention could have resulted in fibrosis and development of a hideous scar. Therefore, it was decided to treat the defect by local application of a PRF membrane.\nAbout 10 ml of venous blood was withdrawn to prepare PRF by Choukroun's protocol [].[] The sampled blood was transferred into glass test tubes. It was then centrifuged at 3000 rpm for 10 min in a laboratory centrifuge. At the end of the centrifugation, three distinct layers could be seen in the test tube. The uppermost layer was platelet poor plasma, the middle layer was platelet rich fibrin, and the lowermost layer was red blood cells. The middle layer of PRF was separated and squeezed between two layers of sterile gauze. The PRF membrane thus obtained was placed over the defect []. A double layer of the membrane was placed over deeper areas of the defect to achieve an even surface. Neglecting this step could lead to an uneven surface and formation of a scar on healing; this was covered by a single layer of moist gauze and micropore dressing. A gradual decrease in the size of the wound and granulation tissue formation was observed in the subsequent visits []. There were no signs of inflammation or infection. It was observed that the PRF-treated site showed hastened healing with early wound contracture. In the subsequent visits, the color of the reconstructed region was comparable to the adjacent uninjured tissue. The defect in the vermilion border and the white roll was inconspicuous [].