The immunogenicity of glycerol-preserved donor skin

Hettich, R.; Ghofrani, Afschin

doi:10.1016/0305-4179(94)90095-7

Cited by 16 publications

(12 citation statements)

References 22 publications

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“… 27 Cryopreservation of homografts with glycerol is the most popular method of cadaver skin processing since freeze‐drying is too expensive and glutaraldehyde fixation is less efficient. 28 Moreover, skin preservation can reduce the risk of virus transmission from skin grafting, providing time to rid the donor skin of pathogens. Indeed, incubation of cadaver skin for several hours at 37°C in glycerol produces a significant virucidal and bactericidal effect.…”

Section: Wound Coverage With Allogeneic Skinmentioning

confidence: 99%

Modern Aspects of Wound Healing: An Update

Ruszczak

Schwartz

2000

Dermatologic Surgery

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Wound healing is an area of cutaneous medicine in which there have been many recent advances. Interest has focused on the development of an in vitro reconstructed skin, although neither the commercially available products nor the products currently described in experimental studies are able to fully substitute for natural living skin. The substitution of the main component of each wound, the connective tissue matrix, is an advance. Once dermis is reconstructed, the covering of the wound surface with both in vitro expanded epidermis and autologous split-skin transplants is significantly easier and has an improved chance of success. Epidermal stem cells may facilitate functionality of the superficial part of such a system. New experimental and clinical trials are currently under way.

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Section: Wound Coverage With Allogeneic Skinmentioning

confidence: 99%

Modern Aspects of Wound Healing: An Update

Ruszczak

Schwartz

2000

Dermatologic Surgery

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“…Human allograft skin can be preserved by numerous methods: cool storage (2–8°C), cryopreservation (−20 to −196°C), deep freezing, freeze drying or dehydration using high-concentration solutes like glycerol (Kearney 2005). These methods amount to different ranges of allograft skin viability, integrity, microbiological contamination and immunogenicity (Ingham et al 1993; Hettich et al 1994; Richters et al 1997; van Baare et al 1998; Bravo et al 2000; Saegeman et al 2008). Glycerol preserved allograft skin, for example, is non-viable and has been used successfully in burn surgery in the past (Kreis et al 1989; de Backere 1994; Huang et al 2004).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a microbiological screening and acceptance procedure for cryopreserved skin allografts based on 14 day cultures

et al. 2011

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Viable donor skin is still considered the gold standard for the temporary covering of burns. Since 1985, the Brussels military skin bank supplies cryopreserved viable cadaveric skin for therapeutic use. Unfortunately, viable skin can not be sterilised, which increases the risk of disease transmission. On the other hand, every effort should be made to ensure that the largest possible part of the donated skin is processed into high-performance grafts. Cryopreserved skin allografts that fail bacterial or fungal screening are reworked into ‘sterile’ non-viable glycerolised skin allografts. The transposition of the European Human Cell and Tissue Directives into Belgian Law has prompted us to install a pragmatic microbiological screening and acceptance procedure, which is based on 14 day enrichment broth cultures of finished product samples and treats the complex issues of ‘acceptable bioburden’ and ‘absence of objectionable organisms’. In this paper we evaluate this procedure applied on 148 skin donations. An incubation time of 14 days allowed for the detection of an additional 16.9% (25/148) of contaminated skin compared to our classic 3 day incubation protocol and consequently increased the share of non-viable glycerolised skin with 8.4%. Importantly, 24% of these slow-growing microorganisms were considered to be potentially pathogenic. In addition, we raise the issue of ‘representative sampling’ of heterogeneously contaminated skin. In summary, we feel that our present microbiological testing and acceptance procedure assures adequate patient safety and skin availability. The question remains, however, whether the supposed increased safety of our skin grafts outweighs the reduced overall clinical performance and the increase in work load and costs.

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“…Cryopreserved allograft (CryoPA) is frozen in liquid nitrogen at -180°C and Glycerol preserved allograft (GPA) is stored in 85% glycerol at 4°C. Cryopreservation has been shown to maintain cell viability up to 50% (Bravo et al 2000) but glycerol preservation results in a non-viable skin which is less antigenic (Richters et al 1997) with anti-bacterial and anti-viral properties (Van Baare et al 1994;Hettich et al 1994). Many skin banks employ cryopreservation but the cost and complexity of cryopreservation processes have encouraged some skin banks to adopt glycerolization of cadaveric skin (Mackie 1997;De Backere 1994;Vuola and Pipping 2002).…”

Section: Introductionmentioning

confidence: 98%

Comparing the use of glycerol preserved and cryopreserved allogenic skin for the treatment of severe burns: differences in clinical outcomes and in vitro tissue viability

et al. 2011

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Cryopreserved (CryoPA) and Glycerol-preserved (GPA) skin allografts are commonly used in the treatment of severe burn injuries. However, comparable data on their differences in clinical outcome is scarce. This retrospective review aims to study the effect of allograft viability on clinical outcomes. The records of 48 severe burn patients who either received CryoPA or GPA were reviewed. Key burn mortality determinants were used to match the 2 groups. Clinical outcomes such as mortality rate (MR) and the length of hospital stay (LOS) were obtained. A separate in vitro comparison included histological assessments and the use of tetrazolium reductase activity to compare tissue viability. Both groups showed a comparable profile in burn mortality determinants. Patients who received CryoPA had a lower MR of 25% compared to 34.8% (P=0.250) in the GPA group and a lower LOS of 39.2-45.9 days (P=0.730), respectively. The histological structural integrity was found to be well preserved with both methods although CryoPA was confirmed to be the more viable product (P<0.05). The lower MR associated with CryoPA cannot be totally ignored. However, the mechanism through which viable skin allografts improves MR of severe burns patients remains to be elucidated.

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The immunogenicity of glycerol-preserved donor skin

Cited by 16 publications

References 22 publications

Modern Aspects of Wound Healing: An Update

Modern Aspects of Wound Healing: An Update

Evaluation of a microbiological screening and acceptance procedure for cryopreserved skin allografts based on 14 day cultures

Comparing the use of glycerol preserved and cryopreserved allogenic skin for the treatment of severe burns: differences in clinical outcomes and in vitro tissue viability

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