Treatment of burns and chronic wounds using a new cell transfer dressing for delivery of autologous keratinocytes

Abstract

This study describes a new methodology for delivering cultured autologous keratinocytes to wounds on a sterile medical grade polymer coated with a chemically defined plasma polymerised functional surface containing 20% carboxylic acid (referred to as PPS). Seven patients (two acute major burns and five chronic non-healing wounds) were treated with applications of autologous keratinocytes delivered on a 6 cm diameter medical grade polymer disc whose surface was functionalised by PPS. For initial keratinocyte expansion a split-thickness skin biopsy was taken from each patient followed by keratinocyte isolation and expansion and, where required for repeated applications, freezing down of keratinocytes. After expansion, cells were cultured on the PPS for 2 days then the PPS with cells was inverted onto the patients wound bed to allow cell transfer to wound beds. For two burns patients transfer of cells from PPS onto donor sites was seen for both patients and it appeared to facilitate healing of grafted burns wounds. For five patients with intractable chronic wounds (with nine ulcers in total) repeated applications of cells resulted in complete healing in 5/9 ulcers with a major reduction in ulcer size for all other (4/9) ulcers. This reduction in ulcer size improved the wound conditions for two of these patients such that they were then considered suitable for conventional grafting and orthopaedic surgery respectively. In conclusion, PPS delivery of autologous cells is a promising approach for acute burns injuries and chronic wounds.