The longevity of a bilayered skin substitute after application to venous ulcers.
BACKGROUND
A bilayered skin substitute composed of allogeneic keratinocytes and fibroblasts in a collagen gel has been approved by the US Food and Drug Administration for the treatment of venous and diabetic ulcers. Its mechanism of action has not been fully determined.


OBJECTIVE
To determine the longevity of allogeneic fibroblasts and keratinocytes in a bilayered skin substitute in patients with venous leg ulcers.


METHODS
Ten patients with venous leg ulcers were treated with a bilayered skin substitute on day 0, days 3 to 5, and weeks 1 through 3. Biopsy specimens of the grafted wound were taken. We used polymerase chain reaction analysis to determine whether allogeneic DNA was present in the biopsy specimens.


RESULTS
We detected allogeneic DNA in 2 of 8 specimens at 1 month after initial grafting. Neither of the 2 patients showed persistence of allogeneic DNA at 2 months after initial grafting.


CONCLUSIONS
Allogeneic cells from a bilayered skin substitute do not appear to survive permanently after grafting for treatment of venous leg ulcers. Other mechanisms of action might include cytokine release, structural support, or provision of a moist wound environment.
Phillips
Tania J
TJ
Department of Dermatology, Boston University School of Medicine, 609 Albany St, Boston, MA 02118, USA.
Manzoor
Jasmin
J
Rojas
Adriana
A
Isaacs
Cary
C
Carson
Polly
P
Sabolinski
Michael
M
Young
Jan
J
Falanga
Vincent
V
D003094:Collagen / Q000235:genetics / Q000494:pharmacology* / Q000627:therapeutic use*; D005347:Fibroblasts / Q000187:drug effects* / Q000473:pathology / Q000637:transplantation*; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D015603:Keratinocytes / Q000187:drug effects* / Q000473:pathology / Q000637:transplantation*; D016133:Polymerase Chain Reaction; D017768:Skin, Artificial; D013997:Time Factors; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000235:genetics* / Q000473:pathology / Q000628:therapy*
C117898:Apligraf; D003094:Collagen