Allogeneic vs. Autologous Skin Grafts in the Therapy of Patients with Burn Injuries: A Restrospective, Open-label Clinical Study with Pair Matching

Kitala, Diana; Klama-Baryła, Agnieszka; Łabuś, Wojciech; Kraut, Małgorzata; Glik, Justyna; Ryszkiel, Ireneusz; Kawecki, Marek; Nowak, Marcin

doi:10.17219/acem/61961

Cited by 31 publications

(26 citation statements)

References 16 publications

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“…This eliminated the need for an own skin transplant to be performed on the patient [49,51]. Similar results have been observed by Oliver and associates, who have proven that allogeneic skin modulates the proliferation process, as well as differentiation of granulation tissue [53].…”

Section: The Allogeneic Skinsupporting

confidence: 64%

“…In certain cases, allogeneic skin serves as a dressing of wounds previously covered by mesh transplants of autologous skin, allowing to minimize metabolic stress and prevent infections within the wound and creating scaffolding for in vitro cultured keratinocytes [42]. In the Center of Wound Treatment in Siemianowice Slaskie, allogeneic skin is the standard operating procedure for patients with severe wounds, allowing for the temporary dressing and protection of wounds [49]. Moreover, it is also used when the exact depth of the wound cannot be determined while a risk of the wound deepening and the loss of the entire autologous transplant exists [50].…”

Section: The Allogeneic Skinmentioning

confidence: 99%

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Advanced Technologies in Dermatology

Kitala¹,

Klama-Baryła²,

Łabuś³

et al. 2018

Dermatologic Surgery and Procedures

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Cellular therapies are an attractive area of regenerative medicine. For large partial thickness wound, keratinocytes transplant is suggested. The transplantation of cell graft is achieved by obtaining large amounts of cultured cells from a skin biopsy in 3 weeks. Stem cells can be applied before that, but are also efficient in chronic wound closure. Alternative treatment methods are transplants of allogeneic, biostatic skin and amnion. Amnion can be applied as a skin substitute on shallow facialburn wounds, hand burn wounds, on donor areas and granulating wounds. For medium depth or even deep burns, allogeneic skin is recommended. Thanks to the removing of cells from human allogeneic dermis, collagen scaffolding is obtained. It can be populated de novo by autologous skin cells. Artificial skin substitutes are especially good for hand burns and shallow burns. Even though scarring is a part of normal wound healing, it often leads to a pathological process. When scar treatment methods prove insufficient, surgical intervention becomes necessary. Surgical scar intervention involves removal of the pathological skin tissue fragment and replacing it with healthy skin or application of expanders. Improvement of the visual features can be also achieved by laser therapy.

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Section: The Allogeneic Skinsupporting

confidence: 64%

Section: The Allogeneic Skinmentioning

confidence: 99%

Advanced Technologies in Dermatology

Kitala¹,

Klama-Baryła²,

Łabuś³

et al. 2018

Dermatologic Surgery and Procedures

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Section: Introductionmentioning

confidence: 99%

“…The optimal method of treatment for extensive full‐thickness skin burns (III°) is to perform an autologous split‐thickness skin graft (STSG) donated from a body part with intact skin (Busuioc et al, ; Glik et al, ; Grossova, Zajicek, Kubok, & Smula, ; Kitala et al, ; Prim et al, ). However, despite total tissue compliance, which should be considered the main advantage of STSG, such grafts have a number of disadvantages and limitations (Kitala et al, ; Table , Figure a). In order to overcome these limitations, the application of biological skin substitutes may be considered (Glik et al, ; Kitala et al, ), the advantage of which may be, for example, the reduction of the donor site surface area and shortening the time of hospitalization of burn patients (Kitala et al, ).…”

Section: Introductionmentioning

confidence: 99%

A new approach to the production of a biovital skin graft based on human acellular dermal matrix produced in‐house, in vitro revitalized internally by human fibroblasts and keratinocytes on the surface

et al. 2019

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Patients with extensive and deep burns who do not have enough donor sites for autologous skin grafts require alternative treatment methods. Tissue engineering is a useful tool to solve this problem. The aim of this study was to find the optimal method for the production of a biovital skin substitute based on acellular dermal matrix (ADM) and in vitro cultured fibroblasts and keratinocytes. In this work, nine methods of ADM production were assessed. The proposed methods are based on the use of the following enzymes: Dispase II, collagenase I/ethylenediaminetetraacetic acid (EDTA), collagenase II/EDTA, and mechanical perforation using DermaRoller and mesh dermatome. The obtained ADMs were examined (both on the side of the basement membrane and on the “cut‐off” side) by means of scanning electron microscopy, immunohistochemistry tests and strength tests. ADM was revitalized with human fibroblasts and keratinocytes. The ability of in‐depth revitalization of cultured fibroblasts and their ability to secrete collagen IV was examined. The obtained results indicate that the optimal method of production of live skin substitutes is the colonization of autologous fibroblasts and keratinocytes on the scaffold obtained using two‐step incubation method: Trypsin/EDTA and dispase II.

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“…Allogeneic skin transplant is a preferred first‐line therapy for burn patients, in particular for those whose wounds do not have sufficient blood vessels to take autologous split‐thickness skin grafts . Allografts not only serve as temporary dressings for burn wounds, they also prepare the wound bed for replacement with autografts later, such as by providing the wound bed with critical growth factors and cytokines for vascularization .…”

Section: Introductionmentioning

confidence: 99%

Recombinant human ADAMTS13 treatment and anti-NET strategies enhance skin allograft survival in mice

Wong

Goverman

Staudinger

2020

American Journal of Transplantation

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Enhancing skin allograft longevity lessens the need for new allografts before optimal intervention is available. Reduced activity of ADAMTS13 (an enzyme that cleaves the pro‐thrombotic and proinflammatory von Willebrand factor) and presence of neutrophil extracellular traps (NETs) have been implicated in liver and lung allograft failures. The effect of ADAMTS13 treatment and the impact of NETs on skin allografts, however, remain unexplored. Here, we adopted a murine model of complete mismatch full‐thickness skin transplant by grafting dorsal skin from BALB/c mice to C57BL/6J background mice. Recombinant human ADAMTS13 (rhADAMTS13) treatment of graft recipients increased allograft survival. Western blot and immunofluorescence microscopy revealed the presence of NETs in allografts of vehicle, but surprisingly, not in rhADAMTS13‐treated mice, 3 days after surgery. Recapitulating the observations in mice, NETs were also observed in all the examined allografts from burn patients. Intriguingly, knocking out peptidylarginine deiminase 4 (PAD4, a key enzyme for NET formation) or DNase 1 treatment (which cleaves NETs) also prolonged allograft survival. In summary, rhADAMTS13 lessens inflammation in allografts by reducing NET burden, resulting in enhanced allograft survival. RhADAMTS13 and anti‐NET treatments could be new therapeutic strategies to promote skin allograft longevity and, hence, the survival of patients with severe burns.

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Allogeneic vs. Autologous Skin Grafts in the Therapy of Patients with Burn Injuries: A Restrospective, Open-label Clinical Study with Pair Matching

Cited by 31 publications

References 16 publications

Advanced Technologies in Dermatology

Advanced Technologies in Dermatology

A new approach to the production of a biovital skin graft based on human acellular dermal matrix produced in‐house, in vitro revitalized internally by human fibroblasts and keratinocytes on the surface

Recombinant human ADAMTS13 treatment and anti-NET strategies enhance skin allograft survival in mice

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