Cultured autologous keratinocytes on a cell-free dermis in the treatment of full-thickness wounds.
The purpose of this study was to establish a method for transplantation of autologous keratinocytes on an allogenic cell-free dermis. From four healthy volunteers two full thickness skin grafts, 1 x 1 cm, were taken. The epidermis was separated from the dermis enzymatically and the cells of the dermal part were removed by incubation in Triton X-100. Keratinocytes were seeded on a cell-free dermis and the combined graft transplanted back to one of the wounds of the donor of the keratinocytes. The other wound was covered with cell-free dermis without keratinocytes. After 2, 3, 4 and 6 weeks, respectively, the grafted wounds were removed from the subjects and investigated histologically and immunohistochemically regarding re-epithelialisation, fibroblast ingrowth and angiogenesis. The wounds covered with cell-free dermis and keratinocytes showed a complete epidermal coverage 2 weeks after transplantation, in contrast to the wounds covered with un-seeded dermis which only showed epidermal coverage at the wound edges. There was also a marked difference concerning fibroblast ingrowth and angiogenesis. In this study we have shown that autologous keratinocytes can be seeded on a cell-free dermis and transplanted as a kerato-dermal graft which stimulate re-epithelialisation as well as fibroblast ingrowth and angiogenesis in the wound.
Gustafson
C J
CJ
Department of Reconstructive Plastic Surgery, Karolinska Hospital, Stockholm, Sweden.
Kratz
G
G
D000328:Adult; D002465:Cell Movement; D062109:Dermatologic Surgical Procedures; D020405:Dermis / Q000033:anatomy & histology / Q000637:transplantation*; D004817:Epidermis / Q000033:anatomy & histology; D004848:Epithelium / Q000473:pathology; D005347:Fibroblasts / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D007150:Immunohistochemistry; D015603:Keratinocytes / Q000473:pathology / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D012867:Skin / Q000098:blood supply / Q000293:injuries / Q000473:pathology; D014021:Tissue Preservation; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous