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Aggarwal et al. Plast Aesthet Res 2018;5:47 I http://dx.doi.org/10.20517/2347-9264.2018.65 Page 3 of 7

Figure 1. Autologous platelet rich plasma being injected immediately following grafting in patient 4 (Patient S. No. 4)

Tangential excision and autologous split skin grafting was performed for deep dermal burns on day 3
following burns. The cause of the deep burn was thermal in all the cases.

The skin grafts were harvested using a Humby’s knife by an experienced surgeon.

Patients with comorbid conditions like diabetes, collagen vascular diseases or any other disease which limits
wound healing were excluded. Patients under mechanical ventilation were not taken up for surgery, and
hence excluded.

Patients were informed about the study and included after providing signed informed consent.

APRP preparation was done in the operation theatre while debridement/dressing change of the patient using
standard and validated technique was described.

Four point five mL of whole blood was taken from a vein in the periphery and 0.5 mL of 3.2% sodium citrate
was added to it (blood: anticoagulant at 9:1). The centrifugation tube was placed in centrifugation apparatus.
The solution was then subjected to centrifugation at 3000 rpm for 10 min. Three portions were seen in the
tube post centrifugation: upper portion containing plasma and platelets, middle portion containing white
blood cells with some platelets (buffy coat) and lower portion containing red blood cells. Out of these,
middle and lower portions are discarded, the upper portion was transferred and taken in a new tube for
re-centrifugation at 4000 rpm for 10 min. Following which two portions were seen: upper 2/3rd portion
containing platelet poor plasma and lower 1/3rd portion which contained platelet rich plasma. Lower 1/3rd
portion was used for APRP therapy.

Multiple subcutaneous injections of 2-3 mL of APRP were given in the selected burn wound following
excision of the deep dermal burns using syringe fitted with 26G needle. APRP injection was done on periphery
of the residual raw area, and also on the donor areas of the skin grafts. APRP injection was done on excision
and subsequently on every dressing change (day 5, day 7, day 10, day 14 post grafting) [Figure 1].