Expanding into the future: Combining a novel dermal template with distinct variants of autologous cultured skin substitutes in massive burns

Schiestl, Clemens; Meuli, Martin; Vojvodic, Miliana; Pontiggia, Luca; Neuhaus, Diego; Brotschi, Barbara; Ernst, Rolf; Böttcher‐Haberzeth, Sophie; Neuhaus, Kathrin

doi:10.1016/j.burnso.2021.06.002

Cited by 13 publications

(8 citation statements)

References 29 publications

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“…Overall, based on these data, the three biopolymer scaffolds used to fabricate engineered skins produced a permanent skin replacement, promoting wound closure with epithelialisation and vascularisation with similar biophysical properties to the skin autograft. Therefore, taking into consideration their disadvantages and advantages, any one of these formulations would reduce the requirement for skin autografts, and the plausibility of laboratory‐based skin as a replacement is feasible 5,48 . A trending effect was observed in this preliminary study, with prospective studies being required to decrease conditions to allow greater sample sizes in order to provide stronger statistical analysis and conclusions.…”

Section: Discussionmentioning

confidence: 84%

“…Therefore, taking into consideration their disadvantages and advantages, any one of these formulations would reduce the requirement for skin autografts, and the plausibility of laboratory-based skin as a replacement is feasible. 5,48 A trending effect was observed in this preliminary study, with prospective studies being required to decrease conditions to allow greater sample sizes in order to provide stronger statistical analysis and conclusions.…”

Section: Evaluation Of Histochemical Stainingmentioning

confidence: 76%

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Comparison of biopolymer scaffolds for the fabrication of skin substitutes in a porcine wound model

Dearman

Boyce

Greenwood

2022

Wound Repair Regeneration

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This study compared three acellular scaffolds as templates for the fabrication of skin substitutes. A collagen-glycosaminoglycan (C-GAG), a biodegradable polyurethane foam (PUR) and a hybrid combination (PUR/C-GAG) were investigated. Scaffolds were prepared for cell inoculation. Fibroblasts and keratinocytes were serially inoculated onto the scaffolds and co-cultured for 14 days before transplantation. Three pigs each received four full-thickness 8 cm Â 8 cm surgical wounds, into which a biodegradable temporising matrix (BTM) was implanted. Surface seals were removed after integration (28 days), and three laboratory-generated skin analogues and a control split-thickness skin graft (STSG) were applied for 16 weeks. Punch biopsies confirmed engraftment and re-epithelialisation. Biophysical wound parameters were also measured and analysed. All wounds showed greater than 80% epithelialisation by day 14 post-transplantation. The control STSG displayed 44% contraction over the 16 weeks, and the test scaffolds, C-GAG 64%, Hybrid 66.7% and PUR 67.8%. Immunohistochemistry confirmed positive epidermal keratins and basement membrane components (Integrin alpha-6, collagens IV and VII). Collagen deposition and fibre organisation indicated the degree of fibrosis and scar produced for each graft. All scaffold substitutes re-epithelialised by 4 weeks. The percentage of original wound area for the Hybrid and PUR was significantly different than the STSG and C-GAG,

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Section: Discussionmentioning

confidence: 84%

Section: Evaluation Of Histochemical Stainingmentioning

confidence: 76%

Comparison of biopolymer scaffolds for the fabrication of skin substitutes in a porcine wound model

Dearman

Boyce

Greenwood

2022

Wound Repair Regeneration

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“…In complex and multi-phasic wound healing, surgical techniques and classical pharmacotherapies often present many limitations with regards to restoration of the cutaneous barrier. Therefore, intense development efforts at the frontiers of surgery, bioengineering, and transplantation science have been deployed over the past half-century, notably in the domain of burn wound care [ 41 , 42 , 43 , 44 , 45 , 46 , 47 ]. Novel biomaterial-based or cellular-based therapeutic solutions have demonstrably moved translational and clinical practices several steps toward closing the gap between patient needs and the availability of optimal skin substitutes and wound coverages in cutaneous regenerative medicine [ 10 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Retrospectives on Three Decades of Safe Clinical Experience with Allogeneic Dermal Progenitor Fibroblasts: High Versatility in Topical Cytotherapeutic Care

et al. 2023

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Allogeneic dermal progenitor fibroblasts constitute cytotherapeutic contenders for modern cutaneous regenerative medicine. Based on advancements in the relevant scientific, technical, and regulatory fields, translational developments have slowly yet steadily led to the clinical application of such biologicals and derivatives. To set the appropriate general context, the first aim of this study was to provide a current global overview of approved cell and gene therapy products, with an emphasis on cytotherapies for cutaneous application. Notable advances were shown for North America, Europe, Iran, Japan, and Korea. Then, the second and main aim of this study was to perform a retrospective analysis on the various applications of dermal progenitor fibroblasts and derivatives, as clinically used under the Swiss progenitor cell transplantation program for the past three decades. Therein, the focus was set on the extent and versatility of use of the therapies under consideration, their safety parameters, as well as formulation options for topical application. Quantitative and illustrative data were summarized and reported for over 300 patients treated with various cell-based or cell-derived preparations (e.g., progenitor biological bandages or semi-solid emulsions) in Lausanne since 1992. Overall, this study shows the strong current interest in biological-based approaches to cutaneous regenerative medicine from a global developmental perspective, as well as the consolidated local clinical experience gathered with a specific and safe allogeneic cytotherapeutic approach. Taken together, these current and historical elements may serve as tangible working bases for the further optimization of local and modern translational pathways for the provision of topical cytotherapeutic care.

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“…In contrast, autologous engineered skin provides immediate coverage with a stratified epidermis that suppresses granulation tissue and arrests the scarring process. Producing a favourable smooth, pliable, even skin, with a reduction in pain and itch (55,68,107). Another major strength and benefit over skin autografts is the reduction of autologous donor skin and its associated morbidities.…”

Section: The Current State Of Bioengineered Dermal-epidermal Substitutesmentioning

confidence: 99%

Advances in Skin Tissue Bioengineering and the Challenges of Clinical Translation

2021

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Skin tissue bioengineering is an emerging field that brings together interdisciplinary teams to promote successful translation to clinical care. Extensive deep tissue injuries, such as large burns and other major skin loss conditions, are medical indications where bioengineered skin substitutes (that restore both dermal and epidermal tissues) are being studied as alternatives. These may not only reduce mortality but also lessen morbidity to improve quality of life and functional outcome compared with the current standards of care. A common objective of dermal-epidermal therapies is to reduce the time required to accomplish stable closure of wounds with minimal scar in patients with insufficient donor sites for autologous split-thickness skin grafts. However, no commercially-available product has yet fully satisfied this objective. Tissue engineered skin may include cells, biopolymer scaffolds and drugs, and requires regulatory review to demonstrate safety and efficacy. They must be scalable for manufacturing and distribution. The advancement of technology and the introduction of bioreactors and bio-printing for skin tissue engineering may facilitate clinical products' availability. This mini-review elucidates the reasons for the few available commercial skin substitutes. In addition, it provides insights into the challenges faced by surgeons and scientists to develop new therapies and deliver the results of translational research to improve patient care.

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Expanding into the future: Combining a novel dermal template with distinct variants of autologous cultured skin substitutes in massive burns

Cited by 13 publications

References 29 publications

Comparison of biopolymer scaffolds for the fabrication of skin substitutes in a porcine wound model

Comparison of biopolymer scaffolds for the fabrication of skin substitutes in a porcine wound model

Retrospectives on Three Decades of Safe Clinical Experience with Allogeneic Dermal Progenitor Fibroblasts: High Versatility in Topical Cytotherapeutic Care

Advances in Skin Tissue Bioengineering and the Challenges of Clinical Translation

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