Autologous bilayered self-assembled skin substitutes (SASSs) as permanent grafts: a case series of 14 severely burned patients indicating clinical effectiveness
| Autor: | Lucie Germain, C Beaudoin Cloutier, L Duranceau, A Dumas, A. Bussière, J Kanevsky, Y Leclerc, P. Bortoluzzi, Hervé Genest, I. Perreault, Danielle Larouche, M T Nguyen, B M Knoppers, B Nedelec, Véronique J. Moulin, Jennifer Lee, Vincent Bernier, E Boghossian, François A. Auger, L. Caouette-Laberge |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty skin lcsh:Diseases of the musculoskeletal system Erythema Cell Survival Clinical effectiveness lcsh:Surgery regenerative medicine Kaplan-Meier Estimate Transplantation Autologous Self assembled 03 medical and health sciences Dermis Skin substitutes Humans Medicine burn tissue culture connective tissue skin grafts Skin Artificial integumentary system business.industry Epithelial Cells Skin Transplantation lcsh:RD1-811 culture techniques Elasticity Surgery Transplantation Treatment Outcome 030104 developmental biology medicine.anatomical_structure tissue engineering Female medicine.symptom lcsh:RC925-935 Burns business Total body surface area Autologous Skin elasticity tissue therapy |
| Zdroj: | European Cells & Materials, Vol 36, Pp 128-141 (2018) |
| ISSN: | 1473-2262 |
| Popis: | Split-thickness skin autografts (AGs) are the standard surgical treatment for severe burn injuries. However, the treatment of patients with substantial skin loss is limited by the availability of donor sites for skin harvesting. As an alternative to skin autografts, our research group developed autologous self-assembled skin substitutes (SASSs), allowing the replacement of both dermis and epidermis in a single surgical procedure. The aim of the study was to assess the clinical outcome of the SASSs as a permanent coverage for full-thickness burn wounds. Patients were recruited through the Health Canada's Special Access Program. SASSs were grafted on debrided full-thickness wounds according to similar protocols used for AGs. The graft-take and the persistence of the SASS epithelium over time were evaluated. 14 patients received surgical care with SASSs. The mean percentage of the SASS graft-take was 98 % (standard deviation = 5) at 5 to 7 d after surgery. SASS integrity persisted over time (average follow-up time: 3.2 years), without noticeable deficiency in epidermal regeneration. Assessment of scar quality (skin elasticity, erythema, thickness) was performed on a subset of patients. Non-homogeneous pigmentation was noticed in several patients. These results indicated that the SASS allowed the successful coverage of full-thickness burns given its high graft-take, aesthetic outcome equivalent to autografting and the promotion of long-term tissue regeneration. When skin donor sites are in short supply, SASSs could be a valuable alternative to treat patients with full-thickness burns covering more than 50 % of their total body surface area. |
| Databáze: | OpenAIRE |
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