Use of an autologous bioengineered composite skin in extensive burns: Clinical and functional outcomes. A multicentric study

Gómez, Claudia Marcela Arenas; Galán, Jacobo; Torrero, V Ayerbe; Ferreiro, I.; Pérez, Daniel; Palao, R.; Martínez, E.; Llames, Sara; Meana, Álvaro; Holguín, Purificación

doi:10.1016/j.burns.2010.10.005

Cited by 43 publications

(29 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some models of bilayered skin substitutes produced in the laboratory have been reported to allow permanent coverage of full-thickness wound, to reduce the need for harvesting autografts, and are indicated as an adjunct treatment for massive burns. 1–3 …”

Section: Introductionmentioning

confidence: 99%

Improved Methods to Produce Tissue-Engineered Skin Substitutes Suitable for the Permanent Closure of Full-Thickness Skin Injuries

Larouche

Cantin-Warren

Desgagné

et al. 2016

BioResearch Open Access

View full text Add to dashboard Cite

There is a clinical need for skin substitutes to replace full-thickness skin loss. Our group has developed a bilayered skin substitute produced from the patient's own fibroblasts and keratinocytes referred to as Self-Assembled Skin Substitute (SASS). After cell isolation and expansion, the current time required to produce SASS is 45 days. We aimed to optimize the manufacturing process to standardize the production of SASS and to reduce production time. The new approach consisted in seeding keratinocytes on a fibroblast-derived tissue sheet before its detachment from the culture plate. Four days following keratinocyte seeding, the resulting tissue was stacked on two fibroblast-derived tissue sheets and cultured at the air–liquid interface for 10 days. The resulting total production time was 31 days. An alternative method adapted to more contractile fibroblasts was also developed. It consisted in adding a peripheral frame before seeding fibroblasts in the culture plate. SASSs produced by both new methods shared similar histology, contractile behavior in vitro and in vivo evolution after grafting onto mice when compared with SASSs produced by the 45-day standard method. In conclusion, the new approach for the production of high-quality human skin substitutes should allow an earlier autologous grafting for the treatment of severely burned patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Improved Methods to Produce Tissue-Engineered Skin Substitutes Suitable for the Permanent Closure of Full-Thickness Skin Injuries

Larouche

Cantin-Warren

Desgagné

et al. 2016

BioResearch Open Access

View full text Add to dashboard Cite

show abstract

“…61 To obtain an inexpensive substitute, another evaluation strategy was to graft autologous fibroblasts and keratinocytes with plasma from the blood bank. 62 In this study, 25 burned patients (74% TBSA) were treated with a final 49% successful engraftment. Fewer infections concomitant to graft were significantly associated with better engraftment, and cosmetic and functional outcomes were satisfactory 4 years later.…”

Section: Tissue Engineering and Cell Graftsmentioning

confidence: 99%

Epidermal Healing in Burns

Mcheik

Barrault²,

Levard

et al. 2014

Plastic and Reconstructive Surgery Global Open

View full text Add to dashboard Cite

Background:Treatment of burned patients is a tricky clinical problem not only because of the extent of the physiologic abnormalities but also because of the limited area of normal skin available.Methods:Literature indexed in the National Center (PubMed) has been reviewed using combinations of key words (burns, children, skin graft, tissue engineering, and keratinocyte grafts). Articles investigating the association between burns and graft therapeutic modalities have been considered. Further literature has been obtained by analysis of references listed in reviewed articles.Results:Severe burns are conventionally treated with split-thickness skin autografts. However, there are usually not enough skin donor sites. For years, the question of how covering the wound surface became one of the major challenges in clinical research area and several procedures were proposed. The microskin graft is one of the oldest methods to cover extensive burns. This technique of skin expansion is efficient, but results remain inconsistent. An alternative is to graft cultured human epidermal keratinocytes. However, because of several complications and labor-intensive process of preparing grafts, the initial optimism for cultured epithelial autograft has gradually declined. In an effort to solve these drawbacks, isolated epithelial cells from selecting donor site were introduced in skin transplantation.Conclusions:Cell suspensions transplanted directly to the wound is an attractive process, removing the need for attachment to a membrane before transfer and avoiding one potential source of inefficiency. Choosing an optimal donor site containing cells with high proliferative capacity is essential for graft success in burns.

show abstract

“…But one way to combine both approaches is the use of clotted human plasma that results in the formation of a plasma-based fibrin matrix (hPBM): a fibrin scaffold containing all plasma factors without platelets. hPBM have been more recently used as skin scaffolds in vitro, in vivo (Alexaline et al, 2015;Llames et al, 2004;Monfort, Soriano-Navarro, Garcia-Verdugo, & Izeta, 2013) and on patients (Gomez et al, 2011;Llames et al, 2006;Mohamed Haflah et al, 2018) showing interesting properties in skin bioengineering. Indeed, we have previously shown that human plasma-based epidermal substitutes (hPBES) have a better regenerative potential than conventional CEAs, with less clonal conversion (Alexaline et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Influence of fibrin matrices and their released factors on epidermal substitute phenotype and engraftment

Alexaline

Magne

Rodríguez

et al. 2019

J Tissue Eng Regen Med

View full text Add to dashboard Cite

SUMMARY Cultured epithelial autografts (CEAs) represent a life‐saving surgical technique for full‐thickness skin burns covering more than 60% total body surface area. However, CEAs present numerous drawbacks leading to heavy cosmetic and functional sequelae. In our previous study, we showed that human plasma‐based fibrin matrices (hPBM) could improve the reparative potential of CEAs. Therefore, in the present work, we sought to investigate the role of hPBM compared with fibrin from purified fibrinogen (FPF) or plastic support on epidermal substitute formation and engraftment. The use of hPBM for epidermal substitute culture improved keratinocyte migration, proliferation, and epidermal substitute organization to a better extent than FPF in vitro. Both fibrin matrices favored greater dermal–epidermal junction protein deposition and prevented their degradation. Keratinocyte differentiation was also decreased using both fibrin matrices. Basement membrane protein deposition was mainly influenced by matrix whereas growth factors released from fibrin especially by hPBM were shown to enhance in vitro keratinocyte migration, proliferation, and epidermal substitute organization. Ultimately, epidermal substitutes grown on hPBM displayed better engraftment rates than those cultured on FPF or on plastic support in a NOD‐SCID model of acute wound with the formation of a functional dermal–epidermal junction. Together, these results show the positive impact of fibrin matrices and their released growth factor on epidermal substitute phenotype and grafting efficiency. Fibrin matrices, and especially hPBM, may therefore be of interest to favor the treatment of full‐thickness burn patients.

show abstract

Use of an autologous bioengineered composite skin in extensive burns: Clinical and functional outcomes. A multicentric study

Cited by 43 publications

References 46 publications

Improved Methods to Produce Tissue-Engineered Skin Substitutes Suitable for the Permanent Closure of Full-Thickness Skin Injuries

Improved Methods to Produce Tissue-Engineered Skin Substitutes Suitable for the Permanent Closure of Full-Thickness Skin Injuries

Epidermal Healing in Burns

Influence of fibrin matrices and their released factors on epidermal substitute phenotype and engraftment

Contact Info

Product

Resources

About