title: An allogeneic cultured dermal substitute suitable for treating intractable skin ulcers and large skin defects prior to autologous skin grafting: three case reports.
abstract: Intractable skin ulcers that arise as secondary lesions from disease and full-thickness skin defects that result from skin tumor excision often need autologous skin grafting to close the wound. We developed an allogeneic cultured dermal substitute (CDS) to shorten the time needed to prepare a wound bed suitable for autologous skin grafting. The CDS was prepared by plating normal human fibroblasts on a spongy matrix consisting of hyaluronic acid and atelo-collagen. The allogeneic CDS was then placed on the rinsed wound surface. This procedure was repeated twice a week for up to five weeks, until the wounds were closed by autologous skin grafting. In all three cases, after CDS treatment for two to five weeks, the wound conditions became suitable for skin grafting; these conditions had not been improved by conventional topical treatments, including topical basic fibroblast growth factor (bFGF). Healthy granulation tissue developed rapidly, concomitant with wound size reduction. The present results indicate that CDS is an excellent biological wound dressing for improving wound conditions so that they are suitable for subsequent autologous skin grafting as well as for shortening the treatment duration for skin ulcers and full-thickness skin defects.
authors.affiliation: Department of Dermatology, School of Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Suga
authors.forename: Masayuki
authors.initials: M
authors.lastname: Mizoguchi
authors.forename: Shigenori
authors.initials: S
authors.lastname: Muramatsu
authors.forename: Yuki
authors.initials: Y
authors.lastname: Mizuno
authors.forename: Hideoki
authors.initials: H
authors.lastname: Ogawa
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kubo
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Kuroyanagi
mesh_terms: D000368:Aged; D001684:Biological Dressings; D002081:Buttocks; D002478:Cells, Cultured; D017719:Diabetic Foot / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006085:Graft Survival; D006801:Humans; D007871:Leg Ulcer / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016038:Skin Transplantation / Q000379:methods*; D012883:Skin Ulcer / Q000175:diagnosis / Q000601:surgery; D017768:Skin, Artificial; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*