Randomized Trial Comparing Cryopreserved Cultured Epidermal Allografts With Tulle-Gras in the Treatment of Split-Thickness Skin Graft Donor Sites

Teepe, Robert G. C.; Koch, Richard; Haeseker, Barend

doi:10.1097/00005373-199312000-00008

Cited by 33 publications

(11 citation statements)

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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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“…O’Connor et al (1981) reported the use of autologous keratinocyte cultures for the treatment of burns, and over time an increasing number of culture and delivery systems of epithelial grafts were developed, mainly in the burn care field (Madden et al 1986; Herzog et al 1988; Burt et al 1989; Compton et al 1990; De Luca et al 1989; Bolivar-Flores et al 1990; Fratianne et al 1993; Phillips et al 1993; Rue et al 1993; Teepe et al 1993a; Brychta et al 1995, Rivas-Torres et al 1996; Carsin et al 2000; Hiroko et al 2001; Koller et al 2002; Chester et al 2004), but also in dermatology (Roseeuw et al 1989; Teepe et al 1990; De Luca et al 1992; Marcusson et al 1992; Teepe et al 1993b; Lindgren et al 1998; Beele et al 2005), otology (Somers et al 1997a; Somers et al 1997b) and stomatology (Tsai et al 1997). Unfortunately, due to wide patient-to-patient variation and the lack of controlled clinical research, it is currently difficult to tell whether there is a place for cultured epithelial grafts in the treatment of major burns (Wood et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Feeder layer- and animal product-free culture of neonatal foreskin keratinocytes: improved performance, usability, quality and safety

et al. 2011

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Since 1987, keratinocytes have been cultured at the Queen Astrid Military Hospital. These keratinocytes have been used routinely as auto and allografts on more than 1,000 patients, primarily to accelerate the healing of burns and chronic wounds. Initially the method of Rheinwald and Green was used to prepare cultured epithelial autografts, starting from skin samples from burn patients and using animal-derived feeder layers and media containing animal-derived products. More recently we systematically optimised our production system to accommodate scientific advances and legal changes. An important step was the removal of the mouse fibroblast feeder layer from the cell culture system. Thereafter we introduced neonatal foreskin keratinocytes (NFK) as source of cultured epithelial allografts, which significantly increased the consistency and the reliability of our cell production. NFK master and working cell banks were established, which were extensively screened and characterised. An ISO 9001 certified Quality Management System (QMS) governs all aspects of testing, validation and traceability. Finally, as far as possible, animal components were systematically removed from the cell culture environment. Today, quality controlled allograft production batches are routine and, due to efficient cryopreservation, stocks are created for off-the-shelf use. These optimisations have significantly increased the performance, usability, quality and safety of our allografts. This paper describes, in detail, our current cryopreserved allograft production process.

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“…CEC have been successfully used in the treatment of burns 33,37,38 , leg ulcers 39-41 , split-thickness skin graft donor sites 42,43 , epidermolysis bullosa 44 , surgical wounds post mohs 45 , decubitus ulcers, amputation stump ulcers, rheumatoid ulcers, scleroderma, split-thickness skin graft donor sites, laser removal sites for tattoos 46,47 , and facial dermabrasion wounds. 48 These epidermal cultures seem to act as a potent stimulus to wound healing, but do not survive permanently on the wound bed.…”

Section: Discussionmentioning

confidence: 99%

Factors that Influence Healing in Chronic Venous Ulcers Treated with Cryopreserved Human Epidermal Cultures

Khachemoune

Bello

Phillips

2002

Dermatologic Surgery

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background. Cryopreserved epidermal cultures (CEC) offer an "off the shelf" treatment for chronic wounds. These cultures are derived from neonatal foreskin and grow rapidly in vitro to form epidermal sheets. They do not require a biopsy from the patient, an advantage compared to autografts. They seem to act as a biological dressing, stimulating epithelialization from the wound edges and adnexae, probably through growth factor release. objective. To summarize our recent experience with the use of CEC in chronic venous leg ulcers and to determine the factors that influence healing in chronic venous ulcers treated with CEC. patients and methods. A single arm, open label study including a total of 11 patients with documented venous ulcers was per-formed. The study involved the application of cryopreserved epidermal cultures every other week to nonhealing leg ulcers for a total of 12 weeks or until complete healing of the ulcer. results. A total of 11 patients with one or more leg ulcers were treated. The average age was similar in healed and unhealed groups. Seven patients completely healed after an average of 4.14 CEC applications. Four patients did not heal after a total of 12 CEC applications. conclusion. Predictors for failure to heal after CEC application in our patients were long wound duration, wound size, presence of lipodermatosclerosis, and history of failed prior split-thickness skin grafts.

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Randomized Trial Comparing Cryopreserved Cultured Epidermal Allografts With Tulle-Gras in the Treatment of Split-Thickness Skin Graft Donor Sites

Cited by 33 publications

References 0 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

Feeder layer- and animal product-free culture of neonatal foreskin keratinocytes: improved performance, usability, quality and safety

Factors that Influence Healing in Chronic Venous Ulcers Treated with Cryopreserved Human Epidermal Cultures

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