title: Use of a bioengineered skin equivalent for the management of difficult skin defects after pediatric multivisceral transplantation.
abstract: BACKGROUND
  Primary wound closure is not always possible after pediatric multi-visceral transplantation because of oversized donor organs and/or intestinal or graft edema. We report our experience evaluating the safety and efficacy of Graftskin (Apligraf, Organogenesis, Canton, Mass), a bioengineered bi-layered human skin equivalent, for the management of difficult skin abdominal defects after multivisceral transplantation in a pediatric population.
  
  
  METHODS
  A retrospective chart review was performed of pediatric multivisceral transplantation patients who were treated with Graftskin. Adverse events, course of wound reepithelialization, and time for complete closure were recorded.
  
  
  RESULTS
  Four patients, 7 to 29 months old, were treated with Graftskin. One patient died because of unrelated reasons. Stimulation of the granulation, reepithelialization, and rapid reduction of the wound surface and depth occurred in the other 3 patients. Complete reepithelialization occurred within 5 months. No adverse events were noted.
  
  
  CONCLUSIONS
  Graftskin was a successful treatment for difficult abdominal skin defects after liver and multivisceral transplantation in children.
authors.affiliation: Department of Dermatology, University of Miami School of Medicine, Miami, Florida 33125, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Drosou
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kirsner
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kato
authors.forename: Naveen
authors.initials: N
authors.lastname: Mittal
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Niami
authors.forename: Barbara
authors.initials: B
authors.lastname: Miller
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Tzakis
mesh_terms: D001698:Biomedical Engineering; D002675:Child, Preschool; D004386:Duodenum / Q000637:transplantation; D004947:Esophagus / Q000637:transplantation; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007422:Intestines / Q000637:transplantation; D016031:Liver Transplantation; D008297:Male; D016377:Organ Transplantation / Q000379:methods*; D016035:Pancreas Transplantation; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D017768:Skin, Artificial; D013270:Stomach / Q000637:transplantation; D014945:Wound Healing / Q000502:physiology*
chemical_list: D007166:Immunosuppressive Agents