Treatment of a Full-Thickness Burn Injury With NovoSorb Biodegradable Temporizing Matrix and RECELL Autologous Skin Cell Suspension: A Case Series

Larson, Kenneth; Austin, Cindy L; Thompson, Simon

doi:10.1093/jbcr/irz179

Cited by 40 publications

(17 citation statements)

References 23 publications

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“…Reepithelization of larger wounds with EG7 PTK treatment alone will be challenging due to limited migratory capacity of keratinocytes on granulation tissue. The successful use of EG7 PTK-UR scaffolds for larger skin wounds would most likely be paired with the application of split-thickness skin graft or autologous keratinocyte transplant (104).…”

Section: Discussionmentioning

confidence: 99%

ROS-Degradable Polythioketal Urethane Foam Dressings to Promote Porcine Skin Wound Repair

Patil

Russo

McCune

et al. 2021

Preprint

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Impaired skin healing and progression into chronic wounds is a prevalent and growing medical problem. Porous, resorbable biomaterials can be used as temporary substrates placed into skin defects to support cell infiltration, neo-tissue formation, and remodeling of nonhealing wounds. Naturally-derived biomaterials have promising healing benefits, but their low mechanical properties and exuberant costs limit their performance and use. Synthetic materials can be affordably manufactured and tuned across a broader range of physiochemical properties, but opportunities remain for tailoring them for ideal host immune and regenerative responses. Polyesters are the most clinically-tested class of synthetic biomaterials, but their hydrolysis releases acidic degradation products that can cause autocatalytic degradation processes that are poorly controlled and are not tied to cellular or other biologic activities. Here, we systemically explored a series of ROS-degradable polythioketal (PTK) urethane (UR) foams with varied hydrophilicity as an alternative class of synthetic biomaterials for wound healing. It was found that the most hydrophilic PTK-UR variant, which had 7 ethylene glycol (EG7) repeats flanking each side of each thioketal bond, had the highest ROS reactivity of the PTK-URs tested. In an in vivo porcine excisional skin wound healing model, hydrophilic EG7 PTK-UR foams more effectively promoted tissue integration, ECM deposition, and re-epithelialization of full-thickness skin wound compared to more hydrophobic PTK-UR variants. Resolution of type 1 inflammation and lower foreign body response to scaffold remnants was also observed for EG7 versus more hydrophobic PTK-UR scaffolds. Finally, porcine wound healing studies showed that EG7 PTK-UR foams had similar wound healing response to a collagen-based clinical gold standard product, Integra Bilayer Wound Matrix (BWM), while outperforming polyester UR foam-based NovoSorb Biodegradable Temporizing Matrix (BTM) with respect to increased ECM production, vascularization, and biomaterial-associated immune phenotype. In sum, PTK-UR foams warrant further development toward a new class of synthetic biomaterial foams for skin wound healing applications.

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Section: Discussionmentioning

confidence: 99%

ROS-Degradable Polythioketal Urethane Foam Dressings to Promote Porcine Skin Wound Repair

Patil

Russo

McCune

et al. 2021

Preprint

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“…Cultured keratinocytes, or cultured epithelial autografts (CEA), were first reported in 1981 by O'Connor et al and required 3-5 weeks for the growth in vitro of sheets of epithelial cells from a small biopsy of a patient's normal skin [17,[95][96][97]. Advantages are lack of immunogenicity and negligible donor sites, disadvantages are fragility of the sheets (due to lack of dermal component which is what gives skin its elasticity and strength), high cost, and time for production [95,[98][99][100]. CEA has evolved from culturing cells in sheets which may take up to 5 weeks, to culturing cells in suspension which takes 2-3 weeks [95,97].…”

Section: Skin Substitutesmentioning

confidence: 99%

“…Biodegradable Temporizing Matrix, or BTM ® , is a synthetic polyurethane dermal substitute developed in 2012 by Greenwood that incorporates into the body through ingrowth of blood vessels and fibroblast infiltration [106,107]. Like Integra ® , it contains a sealing membrane that is removed 3-4 weeks after application, allowing the dermal matrix to be skin grafted [17,99]. Preliminary data show decreased contracture rates and decreased infections [99,100].…”

Section: Skin Substitutesmentioning

confidence: 99%

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Contemporary Aspects of Burn Care

Khatib

Jeschke

2021

Medicina

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The past one hundred years have seen tremendous improvements in burn care, allowing for decreased morbidity and mortality of this pathology. The more prominent advancements occurred in the period spanning 1930–1980; notably burn resuscitation, early tangential excision, and use of topical antibiotic dressings; and are well documented in burn literature. This article explores the advancements of the past 40 years and the areas of burn management that are presently topics of active discussion and research.

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“…However, stable healing cannot be achieved in all patients using these techniques. Although some progress has been made using different templates and matrices [ 10 ], these techniques are still dependent on a minimum degree of perfusion of the wound bed, which is not the situation following high voltage electrical trauma, and are limited in the thickness and quality of the soft tissue they provide [ 11 ].…”

Section: Indicationmentioning

confidence: 99%

Implementation and Validation of Free Flaps in Acute and Reconstructive Burn Care

et al. 2021

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Microsurgical free flap reconstruction in acute burn care offers the option of reconstructing even challenging defects in a single stage procedure. Due to altered rheological and hemodynamic conditions in severely burned patients, it bears the risk of a higher complication rate compared to microsurgical reconstruction in other patients. To avoid failure, appropriate indications for free flap reconstruction should be reviewed thoroughly. Several aspects concerning timing of the procedure, individual flap choice, selection and preparation of the recipient vessels, and perioperative measures must be considered. Respecting these specific conditions, a low complication rate, comparable to those seen in microsurgical reconstruction of other traumatic limb defects, can be observed. Hence, the free flap procedure in acute burn care is a relatively safe and reliable tool in the armamentarium of acute burn surgery. In reconstructive burn care, microsurgical tissue transfer is routinely used to treat scar contractures. Due to the more robust perioperative condition of patients, even lower rates of complication are seen in microsurgical reconstruction.

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Treatment of a Full-Thickness Burn Injury With NovoSorb Biodegradable Temporizing Matrix and RECELL Autologous Skin Cell Suspension: A Case Series

Cited by 40 publications

References 23 publications

ROS-Degradable Polythioketal Urethane Foam Dressings to Promote Porcine Skin Wound Repair

ROS-Degradable Polythioketal Urethane Foam Dressings to Promote Porcine Skin Wound Repair

Contemporary Aspects of Burn Care

Implementation and Validation of Free Flaps in Acute and Reconstructive Burn Care

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