A Comparative Examination of the Clinical Outcome and Histological Appearance of Cryopreserved and Fresh Split-Thickness Skin Grafts.
The clinical use of frozen, human allogeneic skin grafts is considered a suitable alternative to freshly harvested allogeneic skin grafts when the latter are not available. However, limited functional and histological information exists regarding the effects of cryopreservation on allogeneic skin grafts, especially those across mismatched histocompatibility barriers. Thus, we performed a side-by-side comparative study of fresh vs frozen skin grafts, across both minor and major histocompatibility barriers, in a miniature swine model. Since porcine skin shares many physical and immunological properties with human skin, our findings have relevance to current clinical practices involving allogeneic grafting and may support future, temporary wound therapies involving frozen xenografts, comprised genetically modified porcine skin. Four miniature swine underwent harvest and grafting of split-thickness skin, with and without cryopreservation, in order to observe autologous grafts and grafts across minor and major histocompatibility barriers. A biopsy of the grafts was done at regular intervals for study of architecture, vascularization, and outcomes. All grafts vascularized without technical complications. Differences were noted in the early appearance of some fresh vs frozen grafts, but no significant difference was observed in overall survival times in any of the experimental groups. These results demonstrate that despite early observable differences in the healing process, cryopreservation and thawing does not significantly affect long-term graft survival or time to rejection, thus supporting the clinical and experimental use of fresh and frozen split-thickness skin grafts as comparable and interchangeable.
Transplantation Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Paul W
PW
Holzer
David A
DA
Leonard
Kumaran
K
Shanmugarajah
Krysta N
KN
Moulton
Zhi Yang
ZY
Ng
Curtis L
CL
Cetrulo
David H
DH
Sachs
D000818:Animals; D001707:Biopsy, Needle; D002056:Burns / Q000601:surgery*; D015925:Cryopreservation / Q000379:methods; D004195:Disease Models, Animal; D006084:Graft Rejection; D006085:Graft Survival; D007150:Immunohistochemistry; D011897:Random Allocation; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology*; D016038:Skin Transplantation / Q000009:adverse effects / Q000379:methods*; D013552:Swine; D013556:Swine, Miniature; D014021:Tissue Preservation / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods; D014945:Wound Healing / Q000502:physiology