Sprayed cultured autologous keratinocytes in the treatment of severe burns: a retrospective matched cohort study

Abstract

Objective: Cultured autologous keratinocytes were used to treat burns since 1981 with many challenges and variable clinical outcome. Our aim was to compare the duration of hospital stay between burned patients received skin grafts with and without cultured autologous keratinocytes, in a retrospective cohort study. Multivariable regression was used to analyse associations between duration of hospital stay and treatment adjusted for age, mortality, size, and depth of the burn. Then, we investigated the differentiation of human stem cell line to keratinocyte-like cells as a future perspective. Results : The median hospital stay in the group given cultured autologous keratinocytes (n=12) was 70 days (10 th – 90 th centile 50-141) and in the matched group 62 days (2 -196) (n=43), p=0.25. The multivariable regression analysis showed a coefficient of 17.36 (95 % CI -17.69 to 52.40), p= 0.32, for hospital stay in the treatment group, compared with the matched group. Our results showed no difference in the duration of hospital stay between the two groups. Therefore, further evaluation for this treatment is needed. Stem cells showed enhanced proliferation and differentiation when cultured on glass surface rather than the classical tissue culture plastic and should be considered for burn management research.

A Novel Combination of Keratinocyte and Autologous Microskin Grafting to Repair Full-Thickness Skin Loss

“…However, severely burned patients with large burn areas lack essential donor sites for microskin grafting. Keratinocytes are a primary cell in the epidermis [21][22][23], and keratinocyte suspension has been used for wound coverage [24]. Therefore, keratinocytes may serve as a solution to the challenge mentioned above, which has been extensively utilized as a seed cell in clinical practice.…”

Clinical Indications of Cultured Epithelial Autografts

“…60 This spray-on technique has also been successfully used clinically as a treatment in several large burn cases. [61][62][63] However, this technique still needs more research to understand its capabilities and applicabilities, as it was demonstrated in a retrospective study by Karlsson et al 64 that there was no significant difference in using spray-on keratinocytes in addition to autologous grafting compared with autologous graft alone.…”

Alloplastic Epidermal Skin Substitute in the Treatment of Burns

“…However, due to the need to wait up to 3 weeks for culturing keratinocyte cells, the wound requires temporary coverage with another dressing [49]. Cultured autologous keratinocytes might be used as a stand-alone dressing or as an additional dressing for autologous skin grafts [50]. This method can significantly shorten the healing time [51].…”