Combination of meshed dermis graft and cultured epithelial autograft for massive burns

Abstract

Rationale:This study reviewed the use of a combination of meshed dermis graft and cultured epithelial autografts (CEA) made in Japan “JACE” (JACE; Japan Tissue Engineering Co., Ltd. Japan) for the treatment of massively burns. JACE is a Green-type CEA. We recently described a method in which we prepare the wound bed for burned patients by using artificial dermis and graft with JACE on a meshed 6:1 split-thickness autograft. In this report, we used a meshed 3:1 split-thickness dermis graft without epithelial cells. There are several reports of combination of using CEA on meshed split-thickness autograft, however this is the first report of using CEA on meshed split-thickness dermis graft.Patient concerns and diagnosis:Between March 2015 and August 2017, 3 burn patients were enrolled in this study. The patients ranged in age from 51 to 66 years. All 3 patients suffered severe burn injury that caused by flame. % Total Body Surface Area (TBSA) burned were ranged from 37.5% to 69%.Interventions:All patients received surgical treatment with tangential excision within a week from admission. We implanted artificial dermis immediately after debridement. Basically, we applied meshed 6:1 split-thickness autografts to the wound bed and covered with JACE. However, in the absence of split-thickness autografts, we used a meshed 3:1 split-thickness dermis graft instead of a meshed 6:1 split-thickness autograft.Outcomes:At 3 weeks after the transplantation of JACE, the take rate for JACE sheets was >60% on the meshed 3:1 split-thickness dermis graft. Furthermore, almost all of the burn wounds had healed at 6 weeks after surgery.Lessons:We observed good results by grafting JACE on meshed 3:1 dermis graft. With this new method, it is possible to cover a large burn wound by harvesting tissue from only a small site.

The use of negative-pressure wound therapy over a cultured epithelial autograft for full-thickness wounds secondary to purpura fulminans in an infant

“…The CEA was applied together with a 6/1,000-inch autologous split-thickness skin graft (SSG) harvested from the right medial thigh and meshed to a 1:6 ratio of expansion as per the modified JACE technique described by Matsumura et al (Fig. 3) [7,8]. The flanks and back were at higher risk of shearing and cell loss than the anterior abdomen, which is why we decided to limit the use of this technique to the anterior abdomen [9].…”

Morphological features of the wound process after skin burns when using cellular technologies in an experimental model

“…The development of optimal methods for restoring the integrity of skin epithelial layer, searching the means to replace the lacking donor resources for patients with extensive deep burns represent an urgent problem of modern combustiology [3,4]. Delayed restoration of the skin integrity causes an increased incidence of purulent-septic complications of burn disease, which are the main cause of fatal outcomes [5,6].…”