Autologous full-thickness skin substitute for healing chronic wounds

The paper’s objective was to develop tissue engineered skin with human origin in order to use to heal wounds. The paper focused on the development of skin in order to heal ulcers. To develop the tissue engineered skin, the investigators harvested a 3-mm biopsy from the patient’s leg. From this sample of human skin, they prepared an acellular human allodermis. Dermal fibroblasts were cultured along with epidermal sheets. The next step was placing epidermal sheets stratum corneum side up onto the allodermis and then culturned in keratinocyte medium for approximately 7 days. The allodermis with the epidermal sheets were then placed on the fibroblasts to allow for migration. With further culturing and addition of growth factors, antibiotics, and growth medium, the tissue engineered skin was ready in three weeks. Within the three week period the epidermis expanded to cover to allordermis, with a surface area of 1.5 cm2 from the original 3-mm biopsy. Like human skin, the engineered skin was comprised of a compact basal layer, spinous layer, granular layer, and statum corneum.

The engineered skin was applied to the skin using Lomateull® H and providone-iodine ointment. The engineered skin was used to treat nineteen ulcers in fourteen patients. The use of engineered skin resulted in pain reduction from the ulcers. Within one week of application, the engineered skin expanded to the surrounding skin of the ulcer. In twelve of the nineteen ulcers, the engineered skin was incorporated into the wound. The median time for healing was 6 weeks. However, in seven of the nineteen ulcers, the skin was not incorporated and could be removed from the wound.

I choose this paper because it demonstrates the effectiveness of using tissue engineered skin in order to treat wounds. This paper shows that a small sample of human skin can be used to create an effective treatment. Tissue engineered skin is an important area of research and development to help the myriad of skin conditions and also treating severe damage, like burns. Although three weeks is a long time to develop the skin, it is a great alternative to skin grafts where a large area of healthy skin is needed.

Gibbs, S., van den Hoogenband, H.M., Kirtschig, G., Richters, C.D., Spiekstra, S.W., Breetveld, M., Scheper, R.J., and de Boer, E.M. “Autologous full-thickness skin substitute for healing chronic wounds.” British Journal of Dermatology 155 (2006): 267-274.

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Full Text Link (UC-elinks):
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2133.2006.07266.x