title: A comparative study of spray keratinocytes and autologous meshed split-thickness skin graft in the treatment of acute burn injuries.
abstract: BACKGROUND
  ReCell (Avita Medical, Northridge, CA) is an autologous cell harvesting (ACH) device that enables a thin split-thickness skin biopsy to be processed to produce a cell population that includes a mixed population of keratinocytes, melanocytes, Langerhans cells, and papillary dermal fibroblasts for immediate delivery via a spray applicator onto a prepared skin surface.
  
  
  METHODS
  In this Institutional Review Board-approved US Food and Drug Administration phase 2 study, the authors prospectively evaluated the treatment of partial-thickness burns in patients with two 320 cm2 areas, 1 area treated with the ACH device and the other with a meshed split-thickness skin graft (MSTSG) as a control. The authors compared the treatment areas for graft take, pigmentation, and color match to surrounding healthy tissue, scarring, and pain.
  
  
  RESULTS
  In this preliminary study, 10 patients were treated with this protocol. Eight patients had 100% take to both treatment areas and 2 patients had significant non-take and graft loss attributable to underexcised wound beds and difficulty with the spray applicator. Pigmentation and color match ratings were identical at week 52 and the Modified Vancouver Scar Scale scores were comparable. One subject rated the autologous cell harvesting site as having a better appearance, while the remaining subjects rated their ACH and MSTSG sites' appearances as being comparable. In early follow-up visits, pain ratings were slightly elevated in the ACH group due to graft healing; however, in visits following week 2, pain ratings at the ACH and MSTSG sites were rated similarly by all patients.
  
  
  CONCLUSIONS
  This preliminary report describes an early experience with the ACH device and the treatment of partial-thickness burn injuries. In this 10-patient series, patients benefitted from having a decreased donor site size and comparable outcomes with MSTSG treatment. While this preliminary underpowered study has provided positive results, there is a learning curve with choosing the proper wound for treatment with the ACH device, as well as with using the device.
authors.affiliation: Indiana University, Indianapolis, IN.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Sood
authors.affiliation: Indiana University, Indianapolis, IN; email: davidroggy@gmail.com.
authors.forename: David Edward
authors.initials: DE
authors.lastname: Roggy
authors.affiliation: Indiana University, Indianapolis, IN.
authors.forename: Madeline Jane
authors.initials: MJ
authors.lastname: Zieger
authors.affiliation: Indiana University, Indianapolis, IN.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Nazim
authors.forename: Brett Colby
authors.initials: BC
authors.lastname: Hartman
authors.affiliation: Indiana University, Indianapolis, IN.
authors.forename: Jeff Thomas
authors.initials: JT
authors.lastname: Gibbs
mesh_terms: D000208:Acute Disease; D000328:Adult; D002056:Burns / Q000473:pathology / Q000628:therapy*; D002478:Cells, Cultured; D002921:Cicatrix / Q000517:prevention & control*; D003646:Debridement / Q000379:methods; D005260:Female; D006801:Humans; D015603:Keratinocytes / Q000473:pathology / Q000637:transplantation*; D008297:Male; D011446:Prospective Studies; D016038:Skin Transplantation / Q000379:methods*; D014182:Transplantation, Autologous / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing