Use of Autologous Platelet-Rich Plasma to Treat Hypertrophic Burn Scars
Condition: Hypertrophic Scar
MeSH terms: Hypertrophy; Cicatrix, Hypertrophic
Intervention: PRP Injection; Saline Injection
Intervention description: 1mL platelet rich plasma will be injected into each 1cm x 1cm area of scar tissue of the experimental half of the scar.; 1mL NS will be injected into each 1cm x 1cm area of scar tissue of the control half of the scar.
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: All patients meeting inclusion/exclusion criteria will be offered enrollment. Using a coin flip, patients will have a 50% chance of receiving PRP injection on the right half of the scar (as opposed to the left half). Multiple scar sites may be enrolled per patient, without limit.
Masking: Single (Participant)
Masking description: Patients will be blinded to which halves of their scar are in either arm of the study. On each visit, before the patient is able to see the contents of syringes used for injection of either normal saline or platelet rich plasma, the syringes will be covered with a white sticker and labeled such that the provider knows which syringe has PRP vs normal saline but the patient does not (PRP is yellow and normal saline is clear). Depending on which side (left vs right) was assigned PRP vs normal saline, the appropriate area will be injected with 1mL/1sq-cm of PRP or normal saline.
Enrollment: 3.0
Sex: All
Minimum age: 18 Years
Maximum age: 70 Years
Healthy volunteers: Accepts Healthy Volunteers
Keywords: platelet rich plasma (PRP); hypertrophic scar; burn scar; tissue repair; vancouver scar scale (VSS); patient and observer scar assessment scale (POSAS)

Summary:

      Hypertrophic burn scars are experienced by more than 70% of burn victims. They are a major
      source of decreased quality of life in burn patients due to pain, decreased range of motion,
      and poor cosmetic appearance. Current treatment strategies (including fat grafting and laser
      resurfacing) are either highly invasive, prohibitively costly, or painful. Autologous
      Platelet Rich Plasma (PRP) does not require anesthesia, and is an inexpensive, safe, fast,
      and less painful alternative that has been recognized for its role in reducing scars
      associated with acne, among other things. While PRP has not been studied specifically in burn
      scars, there is sufficient theoretical and practical evidence that it will improve the
      appearance and feel of these debilitating scars, representing a large potential benefit for
      these patients with minimal associated risk.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Hypertrophic burn scar present on trunk or abdomen

        Exclusion Criteria:

          -  Initial burn injury less than 1 year old

          -  History of chemical or electrical burn

          -  Genetic or acquired conditions that severely affect systemic wound healing or collagen
             formation (vasculitis, diabetes, Ehlers-Danlos syndrome, radiation therapy to the scar
             site or use of immunosuppressive medications within the last year, active cancer)