Autologous and Allogeneic Skin Cell Grafts in the Treatment of Severely Burned Patients: Retrospective Clinical Study

Abstract

BackgroundTransplantation of skin cells (keratinocytes and fibroblasts) cultured in vitro is a method of choice for the treatment of severe and extensive burns in patients with a deficit of donor sites for free split-thickness skin grafts, and when the grave medical condition of the patient excludes the possibility of an operation under general anesthetic. Appropriate amounts of keratinocytes and/or fibroblasts cultured in vitro are grafted as a suspension in platelet-leukocyte-rich gel directly on the prepared acceptor site. Approximately 3 weeks are needed for autologous cell culture to grow. Allogeneic cells are obtained from patients who died before their own autologous cell transplantation. Therefore allogeneic cells are considered as ready to use product. The aim of the study was to evaluate the efficiency of in vitro cultured autologous/allogeneic skin cell grafts in the treatment of burns. Materials and MethodsIn this study a group of 68 patients hospitalized in the Dr Stanisław Sakiel Centre for Burn Treatment in Siemianowice Śląskie and treated with in vitro cultured skin cells suspended in platelet-leukocyte-rich gel were analyzed. ResultsAutologous/allogeneic keratinocytes and fibroblasts transplantation hastens wound closure. ConclusionA major factor in burn treatment is early application of skin cells, so allogeneic cells are more appropriate, because these cells are an on-shelf product. It is especially important in groups of patients with third-degree burn greater than 40%. Allogeneic cells application does not increase hospitalization length in comparison to autologous cells, meaning usage of allogeneic cells in burns treatment is as efficient as autologous cells.