A Comparative Examination of the Clinical Outcome and Histological Appearance of Cryopreserved and Fresh Split-Thickness Skin Grafts

Abstract

Objective The clinical use of frozen, human allogeneic skin grafts is considered a suitable alternative to freshly harvested allogeneic skin grafts when the latter are not available. However, limited functional and histologic information exists regarding the effects of cryopreservation on allogeneic skin grafts, especially those across mismatched histocompatibility barriers. Thus, we performed a side-by-side comparative study of fresh vs. frozen skin grafts, across both minor and major histocompatibility barriers, in a miniature swine model. Since porcine skin shares many physical and immunologic properties with human skin, our findings have relevance to current clinical practices involving allogeneic grafting, and may support future, temporary wound therapies involving frozen xenografts, comprised of genetically modified porcine skin. Methods Four miniature swine underwent harvest and grafting of split thickness skin, with and without cryopreservation, in order to observe autologous grafts and grafts across minor and major histocompatibility barriers. Grafts were biopsied at regular intervals for study of architecture, vascularization, and outcomes. Results All grafts vascularized without technical complications. Differences were noted in the early appearance of some fresh vs. frozen grafts but no significant difference was observed in overall survival times in any of the experimental groups. Conclusion These results demonstrate that despite early observable differences in the healing process, cryopreservation and thawing does not significantly affect long-term graft survival or time to rejection, thus supporting the clinical and experimental use of fresh and frozen split thickness skin grafts as comparable and interchangeable.

Large-gap Peripheral Nerve Repair Using Xenogeneic Transplants in Primates

“…Cryopreservation of xenogeneic skin transplants has been shown to be safe and effective for up to seven years [16], demonstrating no significant or meaningful differences between fresh and frozen transplants.…”

Influence of electron beam irradiation on extracellular matrix of the human allogeneic skin grafts

“…allogeneic nonviable skin grafts, electron beam irradiation, extracellular matrix degradation, sterilization, tissue engineering 1 | BACKGROUND It has been described that the optimal method for the extensive and fullthickness skin burn treatment is a transplantation of autologous split thickness skin grafts (STSG) obtained from an undamaged area of the body (Table 1). [1][2][3][4][5][6] Among many advantages of the autologous STSGs, the compliance with the patient's major histocompatibility complex (MHC) could be listed. This characteristic could be considered as their major advantage.…”

“…It should be emphasized that the donor sites are new wounds that aggravate the patient's general condition. 1,[3][4][5] The donor sites not only contribute to the ailments pain and require analgesic therapy, but are also a potential site of infection, and while healing they leave scars. [3][4][5] These disadvantages can cause some specific complications such as increased hospitalization time, increased number of necessary surgical procedures, and so on.…”

“…1,[3][4][5] The donor sites not only contribute to the ailments pain and require analgesic therapy, but are also a potential site of infection, and while healing they leave scars. [3][4][5] These disadvantages can cause some specific complications such as increased hospitalization time, increased number of necessary surgical procedures, and so on. 1 In order to circumvent these limitations, the application of selected biological skin substitutes such as nonviable allogeneic human skin grafts might be considered.…”

“…1 In order to circumvent these limitations, the application of selected biological skin substitutes such as nonviable allogeneic human skin grafts might be considered. 1,2,5 Among the advantages of nonviable allogeneic human skin grafts application, the decreased area of donor sites and shortened time of hospitalization may be listed. 1 However, it has been shown that in accordance to biological security, the allogeneic skin grafts require the final sterilization prior to clinical application.…”