Studies of surface microarchitecture using a hand-held video microscope in cases of cultured epithelial autografts

The purpose of this study was to evaluate skin texture after cultured epithelial autografting (CEA) by focusing on the surface microarchitecture. From August 1993 through October 1995, CEA was performed to improve the texture of burn scars in 26 patients. The surface microarchitecture was studied using a hand-held video microscope on a long-term basis. In addition, biopsies were obtained from graft sites in 5 patients before CEA and at 1, 3, and 6 months after CEA. Before CEA, observation of the surface microarchitecture of the burn scars showed no skin fields or skin furrows. Histologically, the epidermis had no rete ridges. At 6 months after resurfacing with autologous cultured epithelium, it was possible to recognize skin fields and skin furrows in all patients. The shapes of the newly formed skin fields were similar but not identical to those at the donor site. Histological examination revealed that rete ridges were formed during the same time period. These findings suggest that the improvement in skin texture of burn scars after resurfacing with cultured epithelium depends on the reconstruction of the skin fields.