Abstract
Autologous epidermal cell cultures (CEA) represent a possibility to treat extensive burn lesions, since they allow a significative surface expansion which cannot be achieved with other surgical techniques based on autologous grafting. Moreover currently available CEA preparations are difficult to handle and their take rate is unpredictable. This study aimed at producing and evaluating a new cutaneous biosubstitute made up of alloplastic acellular glycerolized dermis (AAGD) and CEA to overcome these difficulties. A procedure that maintained an intact basement membrane was developed, so as to promote adhesion and growth of CEA on AAGD. Keratinocytes were seeded onto AAGD and cultured up to 21 days. Viability tests and immunohistochemical analysis with specific markers were carried out at 7, 14, and 21 days, to evaluate keratinocyte adhesion, growth, and maturation. Our results support the hypothesis that this newly formed skin substitute could allow its permanent engraftment in clinical application.
Highlights
The burn patient is prone to a complex, articulated, and polymorphous clinical picture, based on a systemic inflammatory response, affecting multiorgan function, with a high mortality rate
The glycerolized allografts were de-epithelialized with three different methods and used as a scaffold for keratinocyte growth and differentiation
The scaffold was nebulized with keratinocytes and cell adhesion analysed by immunohistochemistry and histology
Summary
The burn patient is prone to a complex, articulated, and polymorphous clinical picture, based on a systemic inflammatory response, affecting multiorgan function, with a high mortality rate. As extensive burns generate large areas of necrotic skin, the therapeutic priority is the removal of the necrotic tissue, so as to limit the inflammatory response. Autologous skin grafting is the gold standard for definitive wound coverage, it is difficult to find suitable donor areas in a patient with extensive burns [1, 2]. Dermal skin substitutes may be used to handle the problem of donor site shortage when dealing with major skin loss. There have been enormous advances in the development of skin substitutes over the last 3 decades, there are still major obstacles to be overcome in the quest for an optimal skin substitute
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