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Millions of people around the world are treated in health care sites due to burns every year, and thousands of them die.1 In 2014, the World Health Organization (WHO) estimated that 265,000 deaths were occurring annually worldwide due to burns.1 45,000 burns require treatment in hospitals in the United States each year. Of these cases, 20,000 cases were major burns involving 25% of the body surface area and 4,500 people died.2 Methods to improve the optimal healing process of wounds and tissues are needed to improve survival and quality of life in patients with burns and can also reduce costs incurred due to the treatment of burns.3 Healing on the burn wound is a complex process and involves various cell components and matrix components. Burns have a different healing process when compared to incision or excision wounds. In burns, the process of necrosis occurs progressively and can extend to deeper tissues, thereby inhibiting the reepithelization process. Because the mechanism of healing of burns is different from other injuries, the development of biomaterials for healing burns is needed to reduce the morbidity and mortality of burns.3 Platelet Rich Plasma (PRP) is an autologous product that concentrates large amounts of platelets in a small volume of blood plasma.4 PRP contains a variety of growth factors essential to initiate and accelerate tissue healing and regeneration. Platelet-Rich Plasma (PRP) is a procedure that relatively easy, low cost and minimally invasive to deliver autologous growth factors for wound healing.5 Because of these benefits, PRP is now one of the innovative modalities with excellent potential for healing both chronic and acute wounds such as in diabetic wounds, pressure sores and burns. Fundamentally the mechanism of PRP is molecular and cellular stimulation of normal wound healing, as observed in platelet activation. Platelets can be activated by two types of stimuli including physical stimuli such as heat, cold, and vibration and chemical stimuli such as collagen, lipopolysaccharides and chitosan.6 Chitosan is a polysaccharide derived from chitin which is a natural component obtained from shrimp shells or crabs. Chitosan is relatively easy and inexpensive to achieve because it comes from shrimp shell waste and is processed with relatively simple techniques. Chitosan and its oligomer are found to be able to improve wound healing, especially in the proliferation phase and extracellular matrix formation. Chitosan and its oligomer are known to have excellent biological properties so that they can be applied to various fields. Lysosomes slowly ABSTRACT

Potential combinations of Platelet Rich Plasma (PRP) and chitosan in burn wound management: a review