Allogeneic skin substitutes applied to burns patients

Area of Science:

• Regenerative Medicine
• Tissue Engineering
• Dermatology

Background:

• Early wound resurfacing is ideal but limited by donor site availability.
• Cultured keratinocyte grafts require multiple procedures and cause delays.
• Organotypic skin substitutes offer single-procedure coverage with potential for allogeneic cell use.

Purpose of the Study:

• To evaluate an organotypic skin substitute composed of allogeneic fibroblasts and keratinocytes in burn patients.
• To compare the efficacy of this substitute against traditional meshed split-thickness autografts.
• To assess the survival and integration of allogeneic cells in a burn wound environment.

Main Methods:

• Development of an organotypic skin substitute using allogeneic dermal fibroblasts in collagen gel, overlaid with allogeneic epidermal keratinocytes.
• Grafting of the skin substitute onto tangentially excised burn wounds (<20% total body surface area).
• Side-by-side comparison with meshed split-thickness autografts in the same patients.

Main Results:

• No infections were observed in any grafts.
• The allogeneic skin substitute demonstrated minimal take at 1 week, with only small islands of keratinocytes surviving by 2 weeks.
• Subsequent autografts showed good take, indicating successful coverage after initial substitute failure.

Conclusions:

• The tested organotypic skin substitute is not yet suitable for direct application to burn wounds due to poor graft take.
• The hostile wound bed environment in burns presents a significant challenge for allogeneic cell survival and integration.
• Further research and development are required to enhance the viability and integration of engineered skin substitutes in burn patients.