Histologic comparison of cultured epithelial autograft and meshed expanded split-thickness skin graft.
Histologic appearance of cultured epithelial autograft (CEA) biopsies obtained up to 2100 days after application from patients with burn injuries differs from time-matched, meshed expanded autograft. The CEA interface with underlying bed remained flat for up to 3 years in three of four patients. CEA epidermal rete ridges, if formed subsequently, were fewer, thinner, and shorter, whereas expanded split-thickness skin grafts had well-defined rete ridges after 1 year. CEA basal layer remained separated from its bed up to 50 days after application, and late blister formation was seen on occasion for up to 3 years. The underlying bed was homogeneous up to 2 years; later some beds demonstrated differentiation with superficial, fine, filamentous collagen fibers and deeper, thick collagen fibers. Fine elastin filaments were initially identified in the superficial bed after 1 year in some specimens and in all after 3 years. Delay in rete ridge formation may explain poor adherence and poor stability.
Putland
M
M
Department of Pathology, University of British Columbia, Vancouver, Canada.
Snelling
C F
CF
Macdonald
I
I
Tron
V A
VA
D002056:Burns / Q000473:pathology / Q000601:surgery*; D046508:Culture Techniques; D004847:Epithelial Cells; D004848:Epithelium / Q000637:transplantation*; D006085:Graft Survival; D006801:Humans; D016038:Skin Transplantation / Q000473:pathology*; D013997:Time Factors; D015626:Tissue Expansion