Exosome + PRP Combination Therapy as a Novel Biological Treatment for Acute Facial and Cervical Burns: A Clinical Case Report

INTRODUCTION: Deep dermal burns necessitate debridement and split-thickness skin grafting, culminating in pathological scarring and long-term functional or psychosocial burdens. This is particularly consequential in anatomically sensitive regions like the face and neck. Strategies promoting rapid re-epithelialization and obviating the need for grafting remain a critically unmet need. Here, we report the application of extracellular vesicles + platelet-rich plasma (EV+PRP) combined therapy in an acute facial and cervical burn and contextualize outcomes through comparison with a contemporaneous case from the same injury event. METHODS: Two female patients presented with facial burns following the same incident. Patient A sustained deep partial- and full-thickness burns involving the face and neck-injuries that, based on depth and anatomical location, would conventionally be expected to require operative management with grafting. Instead, EV+PRP therapy was administered as an adjunct to standard wound care. RESULTS: Patient A, who received EV+PRP treatment, demonstrated accelerated re-epithelialization, had minimal inflammatory sequelae, and achieved favorable functional and aesthetic outcomes, ultimately avoiding surgical intervention. In contrast, Patient B, who had sustained more superficial partial-thickness facial burns, was managed conservatively with standard dressings alone. Despite the lesser depth of injury, patient B exhibited comparatively greater clinical evidence of inflammation and physiological stress during the healing course, with less optimal early skin recovery and a higher likelihood of requiring adjunctive interventions for scar modulation. CONCLUSION: This case provides preliminary clinical evidence that combined EV+PRP therapy may substantially enhance wound healing and modulate scarring in acute deep partial- and full-thickness burns in high-risk anatomical regions. The ability to avert grafting in such injuries represents a clinically significant advancement.