Permanent coverage of full skin thickness burns with autologous cultured epidermis and reepithelialization of partial skin thickness lesions induced by allogeneic cultured epidermis: a multicentre study in the treatment of children

Luca, Michele De; Bondanza, Sergio; Cancedda, Ranieri; Tamisan, A.M.; Noto, C.; Muller, L.; Dioguardi, D; Brienza, E.; Calvario, Agata; Zermani, R; Mascio, Donatello Di; Papadia, F

doi:10.1016/0305-4179(92)90105-4

Cited by 38 publications

(12 citation statements)

References 14 publications

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“…It has been established that hCE promotes wound healing when used as allografts in deep dermal burns, 7,14–17 donor sites, 18–21 and chronic ulcers. 22–24 The beneficial effect can be attributed to the production of basement membrane proteins (collagen types IV–VII, laminin, and fibronectin) which enhance cell migration, creating a favorable environment for the ingrowth of keratinocytes from the wound bed and edges.…”

Section: Discussionmentioning

confidence: 99%

Cultured Human Epidermis Combined With Meshed Skin Autografts Accelerates Epithelialization and Granulation Tissue Formation in a Rat Model

Sakamoto¹,

Morimoto²,

Inoie³

et al. 2017

Annals of Plastic Surgery

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IntroductionAs the take rate of cultured epidermal autografts in burn wound treatment is variable, widely expanded meshed auto skin grafts are often used in combination with cultured epidermal autograft to increase the take rate and achieve definitive wound coverage. However, a long time (3–4 weeks) required to prepare a cultured epidermis sheet is a disadvantage. Allogeneic cultured epidermis can be prepared in advance and cryopreserved to be used in combination with auto meshed skin grafts for treating third-degree burns. Nevertheless, the human cultured epidermis (hCE) has not been proved to accelerate wound healing after meshed skin grafting. Here, we investigated the effect of hCE on wound healing in a rat model of meshed skin grafting.Materials and MethodsHuman cultured epidermis was prepared from human neonatal foreskin and assessed by the release of growth factors into the culture medium using enzyme-linked immunosorbent assay. Skin wounds were inflicted on male F344 rats and treated by the application of widely meshed (6:1 ratio) autogenous skin grafts with or without hCE (n = 8 rats per group). Wound area, neoepithelium length, granulation tissue formation, and neovascularization were evaluated on day 7 postgrafting.ResultsHuman cultured epidermis secreted IL-1α, Basic fibroblast growth factor, platelet-derived growth factor-AA, TGF-α, TGF-β1, and vascular endothelial growth factor in vitro. In rats, hCE accelerated wound closure (P = 0.003), neoepithelium growth (P = 0.019), and granulation tissue formation (P = 0.043), and increased the number of capillaries (P = 0.0003) and gross neovascularization area (P = 0.008) compared with the control group.ConclusionsThe application of hCE with meshed grafts promoted wound closure, possibly via secretion of growth factors critical for cell proliferation and migration, suggesting that hCE can enhance the healing effect of widely expanded skin autografts.

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Section: Discussionmentioning

confidence: 99%

Cultured Human Epidermis Combined With Meshed Skin Autografts Accelerates Epithelialization and Granulation Tissue Formation in a Rat Model

Sakamoto¹,

Morimoto²,

Inoie³

et al. 2017

Annals of Plastic Surgery

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“…Cultured keratinocytes, when used without a dermic bed, show disappointing rates of take of about 50% (4,7,8,9,21 ).…”

Section: Discussionmentioning

confidence: 99%

Widely Meshed Autograft Associated with Cultured Autologous Epithelium for the Treatment of Major Burns in Children: Report of 12 Cases

et al. 2000

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This is a retrospective study of the combination of widely meshed autograft and autologous cultured keratinocytes. We used this method faced with the lack of allogenic skin, as an alternate to the Cuono method. Twelve children suffering extensive burn injury (deep burns of 60%+/-16 of the total body surface) underwent this grafting procedure. The surgical treatment consisted of an early surgical excision, with an immediate coverage by autografts as much as possible. When cultured epithelium was available, a large mesh autograft was applied and covered with cultured epidermis sheets during the same operative procedure. The rate of take was of 84% (+/- 12). No secondary graft loss was observed. This means of coverage appeared reliable and resistant. On average, this method allowed the epidermization of 30% (+/-9) of the total body surface of the children. The average hospital stay of the children was 64+/-20 days. All the children recovered to lead a normal life. The school delay after rehabilitation is one year. This technique is an alternative to Cuono's method when allografts are missing. The combination of autograft and autologous cultured epidermis sheets appeared more effective than one of these techniques applied alone, as if the suggested coupling induced a synergy.

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“…The reports on the average take rate of these grafts are, however, conflicting. Reports vary between 20% and 80% graft take 4,33‐37 . The discrepancy between the results of these investigations can be explained by many factors that influence the take of cultured autografts.…”

Section: Discussionmentioning

confidence: 95%

A modified culture system for epidermal cells for grafting purposes: an in vitro and in vivo study

Dorp¹,

Verhoeven²,

Meij

et al. 1999

Wound Repair Regeneration

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A fully differentiated epithelium mimicking the features of native epidermis was obtained in vitro by culturing human or porcine epidermal keratinocytes on polyester filter substrate at the air-liquid interface. In addition, after 2 weeks of culture, hemidesmosome-like structures were formed along the basal area of the plasma membrane of the basal cells at the cell-filter interface. When grafted onto full-thickness skin wounds in pigs, the take of cell sheets detached from the filter with dispase was significantly higher (about 70%) in comparison to mechanically detached keratinocytes (about 15%). With dispase-treated keratinocytes alone, basement membrane formation took place within 7 days postgrafting as judged from the presence of a lamina lucida and positive staining for type IV collagen. Also, numerous hemidesmosomes and anchoring fibrils were observed at the basal cell-"neodermis" interface. The fully differentiated epidermis, generated by culturing keratinocytes at the air-liquid interface and detached from the substrate by dispase-treatment, is less fragile and easier to handle than epidermal autografts obtained by conventional culturing methods. Detachment by a short dispase-treatment appeared in our hands the only method for successful and complete epithelial regeneration in full-thickness wounds.

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Permanent coverage of full skin thickness burns with autologous cultured epidermis and reepithelialization of partial skin thickness lesions induced by allogeneic cultured epidermis: a multicentre study in the treatment of children

Cited by 38 publications

References 14 publications

Cultured Human Epidermis Combined With Meshed Skin Autografts Accelerates Epithelialization and Granulation Tissue Formation in a Rat Model

Cultured Human Epidermis Combined With Meshed Skin Autografts Accelerates Epithelialization and Granulation Tissue Formation in a Rat Model

Widely Meshed Autograft Associated with Cultured Autologous Epithelium for the Treatment of Major Burns in Children: Report of 12 Cases

A modified culture system for epidermal cells for grafting purposes: an in vitro and in vivo study

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