In vivo expansion and regeneration of full‐thickness functional skin with an autologous homologous skin construct: Clinical proof of concept for chronic wound healing

Abstract

A new cell‐tissue technology uses a patient's skin to create an in vivo expanding and self‐organising full‐thickness skin autograft derived from potent cutaneous appendages. This autologous homologous skin construct (AHSC) is manufactured from a small full‐thickness skin harvest obtained from an uninjured area of the patient. All the harvested tissue is incorporated into the AHSC including the endogenous regenerative cellular populations responsible for skin maintenance and repair, which are activated during the manufacturing process. Without any exogenous supplementation or culturing, the AHSC is swiftly returned to the patient's wound bed, where it expands and closes the defect from the inside out with full‐thickness fully functional skin. AHSC was applied to a greater than two‐year old large (200 cm2) chronic wound refractory to multiple failed split‐thickness skin grafts. Complete epithelial coverage was achieved in 8 weeks, and complete wound coverage with full‐thickness functional skin occurred in 12 weeks. At 6‐month follow‐up, the wound remained covered with full‐thickness skin, grossly equivalent to surrounding native skin qualitatively and quantitatively equivalent across multiple functions and characteristics, including sensation, hair follicle morphology, bio‐impedance and composition, pigment regeneration, and gland production.

Open-label Venous Leg Ulcer Pilot Study Using a Novel Autolologous Homologous Skin Construct

“…An autologous homologous skin construct (AHSC) has been developed for the repair and replacement of skin. 14 – 17 It is created from a small harvest of healthy full-thickness skin, which is sent to an FDA-registered manufacturing facility. AHSC manufacturing creates microaggregates, retaining the endogenous regenerative and support cell populations that are responsible for skin repair.…”

“…AHSC manufacturing creates microaggregates, retaining the endogenous regenerative and support cell populations that are responsible for skin repair. 14 , 15 AHSC processing optimizes the aggregates for passive diffusion and activates endogenous pathways involved in skin repair in a physiological media void of enzymes or growth factors. It is not cultured ex vivo but rather returned to the provider in a syringe and can be spread evenly across the wound bed, where the native wound environment supports the autologous aggregates.…”

What to put on (and what to take off) a wound: treating a chronic neuropathic ulcer with an autologous homologous skin construct, offloading and common sense

“…New methods in treating wounds with autologous stem cells may enhance healing by secondary intention and facilitate the regrowth of functional dermal structures [ 1 , 2 ]. We present the case of a patient with a chronic medial heel wound who underwent unsuccessful initial debridement and closure.…”

“…The patient was treated with an autologous homologous skin construct (AHSC) and different offloading methods of varying effectiveness. This AHSC is made from an autologous skin graft, which is modified by increasing the surface area to volume ratio and activating regenerative dermal stem cells [ 2 ].…”

Autologous Homologous Skin Constructs Allow Safe Closure of Wounds: A Retrospective, Noncontrolled, Multicentered Case Series

“… 1 An autologous homologous skin construct (AHSC; SkinTE; PolarityTE, Salt Lake City, Utah) cell-tissue product has been developed for the repair and replacement of skin. 2 – 4 It is produced from a small piece of the patient’s healthy, full-thickness skin. The harvest is sent to a Federal Drug Administration–registered manufacturing facility.…”