Composite grafts of autogenic cultured epidermis and glycerol-preserved allogeneic dermis for definitive coverage of full thickness burn wounds: case reports

Schiozer, Wandir Antonio; Hartinger, A.; Donnersmarck, G. Henckel von; Mühlbauer, W.

doi:10.1016/0305-4179(94)90006-x

Cited by 21 publications

(10 citation statements)

References 15 publications

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“…8,29 Cultured epithelial autografts can also be an epidermal source. Prompted by observations that cultured epithelial autografts were more successful when placed on a dermal base, 30,31 several investigators have studied the ADM in this setting. Successful placement of alternate epithelial sources (cultured epithelial autografts, Meek grafts) have been described in animals 22,32,33 and limited human case reports 34,35 with successful engraftment, normal skin architecture, and acceptable long-term scarring.…”

Section: Advantages/disadvantages Of Admmentioning

confidence: 99%

Acellular Dermal Matrix in the Management of the Burn Patient

Wainwright

Bury

2011

Aesthetic Surgery Journal

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Although the principles of burn management are still primarily focused on survival, as advances are realized in resuscitation, nutrition, and wound management, the functional and aesthetic outcomes following burn injury have become increasingly important. Acellular dermal matrix materials, which allow surgeons to minimize skin graft donor site morbidity in the process of repairing injured areas, play a role in addressing these important issues. Many favorable reports have been published, but they are generally characterized by small sample sizes, limited objective testing, and retrospective analysis. There does appear to be some evidence for ADM application in patient populations in whom donor site availability (those with massive burns) or morbidity (children, the elderly) is a concern, but more studies are needed. In this article, the authors discuss the current applications for ADM in burn management, review the existing literature, and present opportunities for future research.

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Section: Advantages/disadvantages Of Admmentioning

confidence: 99%

Acellular Dermal Matrix in the Management of the Burn Patient

Wainwright

Bury

2011

Aesthetic Surgery Journal

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“…Nach tangentialer oder epifaszialer Nekrektomie wird allogene Spalthaut auf das débridierte Areal aufgelegt. Während Hickerson [12] und Rives [20] hierzu frische oder kryokonservierte Leichenhaut verwenden, benutzen andere Zentren glycerolkonservierte Haut der Euroskin-Bank in Beverwijk, Holland [24]. Nachfolgend kommt es zur Adhärenz und partiellen Einheilung der [12,20].…”

Section: Allogene Hauttransplantation Nach Cuonounclassified

Dermaler Ersatz in der Wundbehandlung

Rennekampff¹,

Pfau²,

Schaller³

2001

Akt Traumatol

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Zusammenfassung. Der Verlust der Dermis wie in Vollhautwunden führt zu erheblichen funktionellen und ästhetischen Komplikationen. Die Anwendung von biosynthetischem, allogenem oder kultiviertem dermalen Ersatz kann zu einer Verbesserung des Ergebnisses beitragen. Ein aus Kollagen-GAG hergestelltes Laminat (Integra) kann nach zellulärer Repopulation in einer zweiten Operation mit Spalthaut gedeckt werden. Allogene zellfreie Dermis kann dagegen simultan mit Spalthaut transplantiert werden und erbringt funktionell und ästhetisch ansprechende Ergebnisse. Der aus Fibroblasten und Polyglactinnetz gezüchtete dermale Ersatz (Dermagraft) kann ebenfalls zur simultanen Transplantation verwendet werden. Dermaler Ersatz kann die Wundheilung funktionell und ästhetisch verbessern.Dermal Replacements in Wound Healing. In the absence of dermis, as in full-thickness wounds, decreased durability, hypertrophic scarring and wound contraction are major sequelae of the healed wound. In this review we report about dermal substitutes for clinical in vivo skin regeneration. A biosynthetic bilaminate Collagen-GAG replacement (Integra) is designed as a template for ingrowth of fibrovascular components and allows epidermal grafting as a second procedure. Simultaneous grafting of split-thickness skin grafts onto allogenic processed acellular dermis (AlloDerm) has been shown to improve function and cosmesis of the wound. A cultured dermal substitute (Dermagraft) consisting of allogenic fibroblasts and biodegradeable polymers is suitable as a dermal substitute for simultaneous grafting. Dermal replacements can improve function and outcome and reduce overall morbidity. EinleitungDie Behandlung von Patienten mit großflächigen Hautverlusten mittels autologer Maschenspalthauttransplantaten oder kultiviertem autologen Epithel ermöglicht es, auch ausgedehnte Vollhautdefekte zu decken. Die Heilung der Maschentransplantate (mesh) ist jedoch in hohem Maße mit Narbenbildung und Narbenkontrakturen verbunden.Das funktionelle und ästhetische Ergebnis ist dabei direkt abhängig von der Dicke und Expansionsrate der Transplantate, wobei im Speziellen der dermale Anteil eine determinierende Rolle einnimmt [22]. Je geringer der Dermisanteil ausfällt, desto ausgeprägter wird die Narbenbildung. Auch die mit kultiviertem Epithel gedeckten Wunden sind aufgrund der fehlenden Dermis durch Narbenbildung, Kontrakturen und erhöhte Vulnerabilität gekennzeichnet [23].

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“…Keratinocytes cultured in vitro represent a hopeful perspective for solving this problem (Rheinwald and Green 1975;Green et al 1979). However, it seems that a mere substitution of the epidermis is not quite satisfactory because a good-quality substitution also requires a corial component (Compton et al 1989;Schiozer et al 1994).…”

Section: Model Skin Dejects Cultured Epidermal Autografts Allocoriumentioning

confidence: 99%

Model Skin Defects in Rats for the Composite Skin Grafts Evaluation

Brychta¹,

Horký²,

Havranová³

et al. 1997

Acta Vet. Brno

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Brychta P., D. Horky, D. Havranova, Z. Janecek, 1. Adler: Model Skin DeJects in Rats Jor the Composite Skin Graft Evaluation. Acta vet. Bmo, 1997,66:23-26. An animal model (rat) was used for the study of the wound healing process. Full-thickness round skin defects, 3 cm in diameter, placed on the dorsal side of the body were made down to muscle fascia. Plastic rings were used to prevent wound contraction and spontaneous epithelialization from the wound edges.In the first step allodermis was prepared using trypsin, and applied into the wound bed. Cultured epidermal autografts were prepared in vitro using modified Rheinwald-Green method, and in the second step applied on the taken allodermis. In this way composite skin grafts consisting of allodermis and cultured epidermal autografts were constructed. The semipermeable dressing was changed three-times a week.The healing process was monitored using both the appearance and light microscopic evaluation. In the experimental group of 10 animals uniform uncomplicated healing of these composite skin grafts occurred.After 3 months, the composite skin grafts acquired a form very similar to intact skin missing only the appendages (hair and glands). In the microscopic view only rather flat rete ridges under the dermo-epidermal junction made the difference between the graft and intact skin. Model skin dejects, cultured epidermal autografts, allocorium, composite skin graftsThe substitution of the skin damaged in its full thickness due to injury, especially bum, has not been resolved quite satisfactorily. Keratinocytes cultured in vitro represent a hopeful perspective for solving this problem (Rheinwald and Green 1975;Green et al. 1979). However, it seems that a mere substitution of the epidermis is not quite satisfactory because a good-quality substitution also requires a corial component (Compton et al. 1989;Schiozer et al. 1994).The aim of the present study was therefore to approach this problem by recombining allogeneic corium and autologous cultured keratinocytes used for covering of a fullthickness skin defect. A rat experimental model was employed. Materials and MethodsTen white laboratory non-inbred female rats, 6 months old, 300-400 g body mass, were used for the experiment (four intact rats were used as the control group).Surgical interventions were performed in general anaesthesia with 0.2 ml Rometar 2% + 0.8 ml Narkoman 5%.kg-1 body mass.A skin sample for keratinocyte cultivation was taken from the right inguinum of a rat. Hair was removed from the skin. the skin was disinfected with "Spitaderm TM", a sample in its full-thickness, 2 x 1 em, was excised in a sterile way and transported into laboratory in Dulbecco -Minimal Essential Medium (D-MEM) with antibiotics. The skin defect was simply sutured.After removal from the transport medium, the skin sample was placed into 0.2% solution of trypsin and incubated at 4 °C for 24 hours. Then it was washed with Phosphate Buffered Saline (PBS), and keratinocytes were loosened mechanically from the corium in a s...

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Composite grafts of autogenic cultured epidermis and glycerol-preserved allogeneic dermis for definitive coverage of full thickness burn wounds: case reports

Cited by 21 publications

References 15 publications

Acellular Dermal Matrix in the Management of the Burn Patient

Acellular Dermal Matrix in the Management of the Burn Patient

Dermaler Ersatz in der Wundbehandlung

Model Skin Defects in Rats for the Composite Skin Grafts Evaluation

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