Autologous keratinocyte suspension in platelet concentrate accelerates and enhances wound healing – a prospective randomized clinical trial on skin graft donor sites: platelet concentrate and keratinocytes on donor sites

Abstract

BackgroundWound healing involves complex mechanisms, which, if properly chaperoned, can enhance patient recovery. The abilities of platelets and keratinocytes may be harnessed in order to stimulate wound healing through the formation of platelet clots, the release of several growth factors and cytokines, and cell proliferation. The aim of the study was to test whether autologous keratinocyte suspensions in platelet concentrate would improve wound healing. The study was conducted at the Lausanne University Hospital, Switzerland in 45 patients, randomized to three different topical treatment groups: standard treatment serving as control, autologous platelet concentrate (PC) and keratinocytes suspended in autologous platelet concentrate (PC + K). Split thickness skin graft donor sites were chosen on the anterolateral thighs of patients undergoing plastic surgery for a variety of defects. Wound healing was assessed by the duration and quality of the healing process. Pain intensity was evaluated at day five.ResultsHealing time was reduced from 13.9 ± 0.5 days (mean ± SEM) in the control group to 7.2 ± 0.2 days in the PC group (P < 0.01). An addition of keratinocytes in suspension further reduced the healing time to 5.7 ± 0.2 days. Pain was reduced in both the PC and PC + K groups. Data showed a statistically detectable advantage of using PC + K over PC alone (P < 0.01).ConclusionThe results demonstrate the positive contribution of autologous platelets combined with keratinocytes in stimulating wound healing and reducing pain. This strikingly simple approach could have a significant impact on patient care, especially critically burned victims for whom time is of the essence.Clinical trial registry informationProtocol Record Identification Number: 132/03Registry URL: http://www.clinicaltrials.gov

Are the Effects of the Cholera Toxin and Isoproterenol on Human Keratinocytes’ Proliferative Potential Dependent on Whether They Are Co-Cultured with Human or Murine Fibroblast Feeder Layers?

“…Nowadays, cultured epithelial cells are used as a model system to study cellular and molecular interactions or mechanisms, and to investigate various skin pathologies [ 2 , 3 , 4 ]. Because this system enables epithelial stem cell retention, autologous keratinocytes can be grafted on patients as cell suspensions or epithelial sheets, thus providing means to treat superficial burns or to facilitate donor site regeneration [ 5 , 6 , 7 , 8 ]. For severe burns and chronic ulcers, cultured bi-layered skin substitutes—containing both dermal and epidermal cells—can also be grafted directly onto affected areas to promote healing [ 9 , 10 , 11 , 12 , 13 ].…”

Effect of leukocyte filtration on the P-selectin expression of apheresis platelets

“…This type of filter is categorized as a depth filter, the main processing of which involves passing through the molecular sieve and physical/chemical adhesion of the materials. The leukocyte removal rate and platelet recovery rate of this filter can reportedly reach 99.8 and 91.29%, respectively (Guerid et al, 2013). CD62P, also known as platelet α-granule membrane protein-140 (GMP-140), is expressed on the platelet plasma membrane during platelet activation, but not on the resting platelet.…”

Randomized clinical trial of autologous skin cell suspension for accelerating re-epithelialization of split-thickness donor sites

“…Guerid and colleagues reported a randomized trial of 45 patients who were treated with autologous keratinocyte suspension in a platelet concentrate, with a mean healing time of 5·7 days. Campanella and co‐workers compared a silicone dressing and a monofilament polyamide woven dressing on paediatric donor sites treated with autologous skin cells, with equivalent rates of epithelialization.…”

“…Cell‐based therapeutic strategies including use of stem cells and autologous skin cells are increasingly important for the treatment of open wounds, and may improve tissue repair and accelerate skin regeneration. Autologous, non‐cultured, heterogeneous skin cell suspension, which can be obtained using the ReCell ® system (Avita Medical, Cambridge, UK), includes 65 per cent keratinocytes, 30 per cent fibroblasts and 3·5 per cent melanocytes.…”