Use of a bioengineered skin equivalent for the management of difficult skin defects after pediatric multivisceral transplantation.
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.
Drosou
Anna
A
Department of Dermatology, University of Miami School of Medicine, Miami, Florida 33125, USA.
Kirsner
Robert S
RS
Kato
Tomoaki
T
Mittal
Naveen
N
Al-Niami
Ahmed
A
Miller
Barbara
B
Tzakis
Andreas G
AG
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*
D007166:Immunosuppressive Agents