Autologous cultured keratinocytes suspensions accelerate re-epithelialization in the diabetic pig

Abstract

Abstract Introduction: Diabetes is one of the leading causes of chronic wounds in the U.S.A. Its incidence is increasing dramatically due to obesity and old age. Healing of these impaired wounds often represent a difficult challenge with the currently available treament. We recently established a delayed wound-healing model in the Yorkshire pig rendered diabetic by administration of Streptozotocin. This study evaluated epidermal regeneration in fluid treated skin wounds treated with suspensions of cultured autologous keratinocytes. Methods: Diabetes was induced by injecting Streptozotocin into a three months old female Yorkshire pig. Full thickness wounds were created on the dorsum and dressed with polyvinyl chambers to keep the wounds wet and to allow for wound fluid monitoring. Suspensions of keratinocytes were seeded into half of the wounds and Normal Saline into the remaining wounds. Serum glucose and wound fluid glucose concentrations were monitored daily. Wound contraction was monitored and biopsies taken on day 12. Results: The serum glucose was significantly increased for the duration of the experiment (>350 mg/dl). Wound fluid glucose closely followed serum glucose concentration. Transplantation of keratinocytes suspensions significantly accelerated re-epithelialization in the diabetic pig. There was no statistical difference between the contraction rates of wounds treated with a keratinocyte suspension or with normal saline. Day 12Normal SalineKeratinocytes suspensionRe-epithelialization47.8%82.6%Wound contraction33.2%32.9% Conclusions: This study shows that wound healing is delayed in the streptozotocin-induced diabetic pig model. A single-cell suspension of keratinocytes not only survives in the hyperglycemic wound environment but also contributes to the formation of a neo-epithelium, accelerating the rate of healing over saline-treated controls.