title: Foreskin-isolated keratinocytes provide successful extemporaneous autologous paediatric skin grafts.
abstract: Severe burns in children are conventionally treated with split-thickness skin autografts or epidermal sheets. However, neither early complete healing nor quality of epithelialization is satisfactory. An alternative approach is to graft isolated keratinocytes. We evaluated paediatric foreskin and auricular skin as donor sources, autologous keratinocyte transplantation, and compared the graft efficiency to the in vitro capacities of isolated keratinocytes to divide and reconstitute epidermal tissue. Keratinocytes were isolated from surgical samples by enzymatic digestion. Living cell recovery, in vitro proliferation and epidermal reconstruction capacities were evaluated. Differentiation status was analysed, using qRT-PCR and immunolabelling. Eleven children were grafted with foreskin-derived (boys) or auricular (girls) keratinocyte suspensions dripped onto deep severe burns. The aesthetic and functional quality of epithelialization was monitored in a standardized way. Foreskin keratinocyte graft in male children provides for the re-epithelialization of partial deep severe burns and accelerates wound healing, thus allowing successful wound closure, and improves the quality of scars. In accordance, in vitro studies have revealed a high yield of living keratinocyte recovery from foreskin and their potential in terms of regeneration and differentiation. We report a successful method for grafting paediatric males presenting large severe burns through direct spreading of autologous foreskin keratinocytes. This alternative method is easy to implement, improves the quality of skin and minimizes associated donor site morbidity. In vitro studies have highlighted the potential of foreskin tissue for graft applications and could help in tissue selection with the prospect of grafting burns for girls.
authors.affiliation: Service de Chirurgie Pédiatrique, CHU de Poitiers, France.|Laboratoire Inflammation, Tissus Epithéliaux et Cytokines (LITEC), Université de Poitiers, France.
authors.forename: Jiad N
authors.initials: JN
authors.lastname: Mcheik
authors.affiliation: BIOalternatives, Gençay, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Barrault
authors.affiliation: BIOalternatives, Gençay, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Pedretti
authors.affiliation: BIOalternatives, Gençay, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Garnier
authors.affiliation: BIOalternatives, Gençay, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Juchaux
authors.affiliation: Service de Chirurgie Pédiatrique, CHU de Poitiers, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Levard
authors.affiliation: Laboratoire Inflammation, Tissus Epithéliaux et Cytokines (LITEC), Université de Poitiers, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Morel
authors.affiliation: Laboratoire Inflammation, Tissus Epithéliaux et Cytokines (LITEC), Université de Poitiers, France.|Laboratoire d'Immunologie et Inflammation, CHU de Poitiers, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Lecron
authors.affiliation: Laboratoire Inflammation, Tissus Epithéliaux et Cytokines (LITEC), Université de Poitiers, France.|BIOalternatives, Gençay, France.
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Bernard
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D002056:Burns / Q000473:pathology; D002454:Cell Differentiation; D002469:Cell Separation / Q000379:methods*; D002478:Cells, Cultured; D002648:Child; D002675:Child, Preschool; D004423:Ear; D000078404:Epidermal Cells; D052816:Foreskin / Q000166:cytology*; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D015603:Keratinocytes / Q000166:cytology*; D008297:Male; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D012038:Regeneration; D016038:Skin Transplantation; D013234:Stem Cells / Q000166:cytology; D014182:Transplantation, Autologous; D014945:Wound Healing
chemical_list: D015415:Biomarkers; D012333:RNA, Messenger
keywords: burns; differentiation; foreskin; graft; keratinocytes; proliferation