Healing of widely meshed autografts using freshly isofated autologous epidermal celíš and acellular xenodermis Xe-Derma
Abstract
In extensively burned patients the major step in complex therapy is the fastest possible closure of the wound. To cover the highest possible extent of the wound bed, the autograft is largely meshed prior to application.
This work aimed to stimulate the epidermal regeneration of spaces (windows) surrounded by bridges of a largely expanded dermo-epidermal graft using autologous epidermal cells and acellular pig dermis Xe-Derma (XD). Cells were obtained from the patienťs skin (1-4 cm2) by the Re-Cell system or by standard trypsinization.
In 14 patients with deep burns a part of the burn area was covered with the autograft meshed 1:3 (8 patients) or 1:6 (6 patients). On one part of the burned area the cells were dropped into the windows of the graft and covered with XD (cells+XD group).
The second part was covered with XD alone (XD group). The third part was covered with Grassolind tulle gras (control).
The wounds covered with the autograft meshed 1:3 had all healed completely in the course of nine days and differences in the healing time were difficult to distinguish. In wounds autografted with 1:6 mesh, epithelization of windows was faster in the areas treated with cells+XD (9-14 days) then with XD alone (12-17 days); the quality of the healed skin was good in both cases.
Healing of the control area covered with Grassolind was prolonged: in 20 days 30-50% of the grafted area had healed, and the epidermis was fragile and disintegrated. The study showed a positive effect of three sandwiched biological covers (largely expanded autograft, autologous skin cells, XD) on healing of widely meshed autografts.
XD without cells also showed a positive healing effect