A new autologous keratinocyte dressing treatment for non-healing diabetic neuropathic foot ulcers.
OBJECTIVE
To evaluate the use of a new cell-tailored carrier surface (TranCell) for delivery of autologous keratinocytes to promote wound healing in patients with chronic neuropathic foot ulcers.


METHODS
TranCell is a sterile medical grade polymer coated with a plasma-polymerized functional surface containing 20% carboxylic acid which enables keratinocytes to attach and proliferate. Six diabetic patients with neuropathic ulcers resistant to conventional therapy were treated with weekly applications of autologous keratinocytes delivered on TranCell. A split-thickness skin biopsy was taken from each patient followed by isolation, expansion and freezing down of keratinocytes. Keratinocytes were thawed and seeded on TranCell 48 h prior to application. This procedure was repeated weekly in addition to conventional therapy until wound healing was achieved.


RESULTS
Complete healing was achieved in six out of nine ulcers in six patients, a reduction in ulcer size was achieved in one ulcer and no response was seen in one ulcer. Treatment was discontinued in one patient due to development of Methicillin-Resistant Staphylococcus aureus (MRSA) after only three applications of TranCell. Wound healing took 6-17 applications over 6-20 weeks. There were no recurrences in the healed ulcers after a follow-up of 6 months.


CONCLUSIONS
TranCell delivery of autologous cells is a promising treatment for chronic diabetic foot ulcers with no side-effects and no recurrence in the healed ulcers.
Moustafa
M
M
Section of Human Metabolism, Division of Clinical Sciences (North), Northern General Hospital, Sheffield S5 7AU, UK.
Simpson
C
C
Glover
M
M
Dawson
R A
RA
Tesfaye
S
S
Creagh
F M
FM
Haddow
D
D
Short
R
R
Heller
S
S
MacNeil
S
S
D000328:Adult; D000368:Aged; D001458:Bandages; D002908:Chronic Disease; D017719:Diabetic Foot / Q000473:pathology / Q000628:therapy*; D006801:Humans; D015603:Keratinocytes / Q000637:transplantation*; D008875:Middle Aged; D017768:Skin, Artificial; D016896:Treatment Outcome; D014945:Wound Healing