Case study: hypertrophic and acne scar treatment A common effective treatment for scars is platelet rich plasma (PRP), which is used frequently here at Dynamic Regenerative Medicine. Patient A is a 36-year-old female who had spinal surgery after an injury that occurred. After surgery she made a full recovery and initially had a very neat scar on the front of the neck on the left side. She followed on with an angry red scar, which had not grown outside the margins of the original wound so was deemed to be a hypertrophic scar. The decision was made to treat the neck scar with PRP as the scar was in a very visible place on the Patient ’s neck. Furthermore, the wound was relatively new.
PRP has growth stimulation properties and was considered more likely to strengthen, rather than weaken gained wounds. Laser therapy seemed impractical due to the wound being so narrow, so collateral damage was likely. Topical treatment and peels were discounted for the same reason. The daily visibility of the scar called for a treatment that would not cause a local reaction making the wound more unsightly during the healing process, thus PRP was deemed, on balance, to be the best option.
PRP for scar treatment
Platelet-rich plasma is made from the patient’s venous blood that has been centrifuged to make it especially rich in platelet cells. Platelets contain several different substances including a useful range of growth factors, all of which stimulate new growth of tissue and blood vessels.
PRP is a relatively new therapy, first used in surgery and now PRP continues to expand into more and more areas as well as more obvious aesthetic applications such as facial treatments and, the subject of this article, scar treatment.
Treatment of PRP
Contraindications to PRP would include bleeding disorders, current warfarin or non-steroidal anti-inflammatory drugs (NSAID) usage or evidence of infection in the area. Possible side effects include bruising, swelling and infection, although rare.
20ml of blood is drawn along with an anticoagulant, which was then centrifuged. The plasma was activated with calcium resulting in 8ml of active PRP. The wound was injected with aliquots of 0.2ml of PRP using multiple punctures. The wound was also underrun with 1ml of plasma at the level of the deep dermis. Review of scar treatment After eight weeks the patient was reviewed and the wound showed a significant improvement. There was a reduction in the redness of the scar, apart from a fine border, which remained hyperaemic. Also, the most lateral portion of the scar remained raised, whilst the rest had flattened completely. The patient was delighted with the response, but was keen to see if further improvement could be achieved, particularly in the lateral region and also in the colour, which she felt still drew attention to the scar and was difficult to disguise without a scarf. A second round of plasma therapy was undertaken at this appointment and the patient was reviewed eight weeks later. At the next review, the lateral portion of the scar can be seen to have responded well and flattened. Also the border has resolved and the scar no longer looks active. An appointment has been made to review the patient six months after the second treatment for final follow up, although no further treatment is planned at the moment. The future of PRP in scar treatment PRP treatment for scars is continuing to show encouraging results and her good clinical outcomes.
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