title: The use of amnion-derived cellular cytokine solution (ACCS) in accelerating closure of interstices in explanted meshed human skin grafts.
abstract: Meshed, split-thickness skin grafts, especially when required to be widely spread, do not obtain immediate biologic closure. In patients with burns that cover a large percentage of the body surface area, this leaves the patient at risk for metabolic problems and life-threatening infection.
  
  
  OBJECTIVE
  The purpose of this study was to determine whether amnion-derived cellular cytokine solution could improve epithelialization kinetics and accelerate closure of meshed skin graft interstices.
  
  
  METHODS
  Human meshed, split-thickness skin grafts were explanted to athymic "nude" rats and treated with 3 different regimens of amnion-derived cellular cytokine solution (groups I, II, and III) or normal saline (group IV) as a control. Serial wound tracings of unepithelialized interstitial wound areas were compared over time. Two different preparations of amnion-derived cellular cytokine solution were also compared with one another, one containing animal components and the other free of animal components.
  
  
  RESULTS
  Only 67.03% of interstices in control animals closed by day 9. This compared with 92.2% closure for group I, 83.72% for group II, and 90.64% for group III. Interstices in all 3 groups treated with amnion-derived cellular cytokine solution (with or without animal-derived components) closed faster statistically than in the control animals (P < .05). There were no statistical differences among the 3 amnion-derived cellular cytokine solution-treated groups.
  
  
  CONCLUSIONS
  These data suggest that epithelialization kinetics and interstitial closure of meshed skin grafts can be accelerated with the use of amnion-derived cellular cytokine solution, a physiologic cocktail of cytokines, and provide support for a future clinical trial.
authors.affiliation: Institute for Tissue Regeneration, Repair, and Rehabilitation, Bay Pines VAHCS, Bay Pines, FL, USA.
authors.forename: M Georgina
authors.initials: MG
authors.lastname: Uberti
authors.forename: Francis
authors.initials: F
authors.lastname: Ko
authors.forename: Yvonne N
authors.initials: YN
authors.lastname: Pierpont
authors.forename: Erika L
authors.initials: EL
authors.lastname: Johnson
authors.forename: Terry E
authors.initials: TE
authors.lastname: Wright
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Smith
authors.forename: Martin C
authors.initials: MC
authors.lastname: Robson
authors.forename: Wyatt G
authors.initials: WG
authors.lastname: Payne