Advertisement
Research Article| Volume 46, ISSUE 3, P228-234, 1993

The effect of backing materials on keratinocyte autograft take

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      A porcine model has been established to study keratinocyte autografts as a model of human keratinocyte grafting. Keratinocyte autografts were placed on 104 full thickness wounds in 13 pigs and backed with 3 dressings which varied in their ability to maintain an occlusive environment. Sixteen control wounds were ungrafted. No take was found using a backing of woven viscose and cotton gauze. Take was 20% at day 16 using a backing of woven viscose and paraffin gauze. Serial biopsies showed that keratinocytes frequently attached to the interstices of the viscose dressing and difficulty in detaching the viscose caused loss of epidermis. Hydrogel sheet backing made assessment at day 10 difficult because of wound hydration but dressing removal, enabling exudate evaporation, produced 22% take at day 13. The development of improved dressing techniques is certainly necessary for improved graft take.

      References

        • O'Connor NE
        • Mulliken JB
        • Banks-Schlegel S
        • Kehinde O
        • Green H
        Grafting of burns with cultured epithelium prepared from autologous epidermal cells.
        Lancet. 1981; 1: 75
        • Gallico III, GG
        • O'Connor NE
        • Compton CC
        • Kehinde O
        • Green H
        Permanent coverage of large burn wounds with autologous cultured human epithelium.
        N Engl J Med. 1984; 311: 448
        • Teepe RGC
        • Ponec M
        • Kreis RW
        • Hermans RP
        Improved grafting method for the treatment of burns with autologous cultured human epithelium (letter).
        Lancet. 1986; 1: 385
        • De Luca M
        • Albanese E
        • Bondanza S
        • Megna M
        • Ugozzoli L
        • Molina F
        • Cancedda R
        • Santi PL
        • Bormioli M
        • Stella M
        • Magliacani G
        Multicentre experience in the treatment of burns with autologous and allogenic cultured epithelium, fresh or preserved in a frozen state.
        Burns. 1989; 15: 303
        • Eldad A
        • Burt A
        • Clark JA
        • Gusterson B
        Cultured epithelium as a skin substitute.
        Burns. 1987; 13: 173
        • Kumagai N
        • Nishina H
        • Tanabe H
        • Hosaka T
        • Ishida H
        • Ogino Y
        Clinical application of autologous cultured epithelia for the treatment of burn wounds and burn scars.
        Plast Reconstr Surg. 1988; 82: 99
        • Herzog SR
        • Meyer A
        • Woodley D
        • Peterson HD
        Wound coverage with cultured autologous keratinocytes: use after burn wound excision, including biopsy followup.
        J Trauma. 1988; 28: 195
        • Compton CC
        • Gill JM
        • Bradford DA
        • Regauer S
        • Gallico GG
        • O'Connor NE
        Skin regenerated from cultured epithelial autografts on full thickness burn wounds from 6 days to 5 years after grafting.
        Lab Invest. 1989; 60: 600
        • Gallico III, GG
        • O'Connor NE
        • Compton CC
        • Remensnyder JP
        • Kehinde O
        • Green H
        Cultured epithelial autografts for giant congenital nevi.
        Plast Reconstr Surg. 1989; 84: 1
        • Teepe RGC
        • Ponec M
        • Kempenaar B
        • Mauw B
        • Scheffer E
        Clinical, histological and ultrastructural aspects of cultured epithelium.
        in: Proceedings of the International Symposium on the clinical use of cultured epithelium in surgery and dermatology, Leiden, The Netherlands Medical and Scientific Conference Ltd, Birmingham, England1987: 36
        • Blight A
        • Mountford EM
        • Cheshire IM
        • Clancy JMP
        • Levick PL
        Treatment of full skin thickness burn injury using cultured epithelial grafts.
        Burns. 1991; 17: 495
        • Leigh IM
        • Purkis PE
        • Navsaria HA
        • Philips TJ
        Treatment of chronic venous ulcers with sheets of cultured allogeneic keratinocytes.
        Br J Dermatol. 1987; 117: 591
        • Billingham RE
        • Reynolds J
        Transplantation studies on sheets of pure epidermal epithelium and on epidermal cell suspensions.
        Br J Plast Surg. 1952; 5: 25
        • Eisenger M
        Regeneration of epidermis by cells grown in tissue culture.
        J Am Acad Dermatol. 1985; 12: 402
        • Igel HJ
        • Freeman AE
        • Boeckman CR
        • Kleinfeld KL
        A new method for covering large surface area wounds with autografts: II. Surgical application of tissue culture and expanded rabbit skin autografts.
        Arch Surg. 1974; 108: 724
        • O'Connor NE
        • Gallico GG
        • Compton CC
        • Kehinde O
        • Green H
        Grafting of burns with cultured epithelium prepared from autologous epithelial cells: II. Intermediate term results on three pediatric patients.
        in: Hunt TK Heppenstall HBS Pines E Soft tissue and hard tissue repair: Biological and clinical aspects. Praeger Publishers, New York1984: 283
        • Aubock J
        • Irschick E
        • Romani N
        • Kompatscher P
        • Hopfl R
        • Herold M
        • Schuler G
        • Bauer M
        • Huber C
        • Fritsch P
        Rejection, after a slightly prolonged survival time of Langerhans cell-free allogenic cultured epidermis used for wound coverage in humans.
        Transplantation. 1988; 45: 730
        • Heck EL
        • Bergstresser PR
        • Baxter CR
        Composite skin grafts: frozen dermal allografts support the engraftment and expansion of autologous epidermis.
        J Trauma. 1985; 25: 106
        • Cuono C
        • Langdon R
        • McGuire J
        Use of cultured epidermal autografts and dermal allografts as skin replacement after burn injury.
        Lancet. 1986; 1: 1123
        • Winter GD
        Epidermal regeneration studied in the domestic pig.
        in: Maiback HI Rovee DT Epidermal wound healing. Year Book Medical Publishers, Chicago1972: 71
        • Montagna W
        • Yun JS
        The skin of the domestic pig.
        J Invest Dermatol. 1964; 43: 11