Novel Application of Cultured Epithelial Autografts (CEA) with Expanded Mesh Skin Grafting Over an Artificial Dermis or Dermal Wound Bed Preparation

Int J Mol Sci. 2017 Dec 25;19(1):57. doi: 10.3390/ijms19010057.

Abstract

Cultured epithelial autografts (CEA) with highly expanded mesh skin grafts were used for extensive adult burns covering more than 30% of the total body surface area. A prospective study on eight patients assessed subjective and objective findings up to a 12-month follow-up. The results of wound healing for over 1:6 mesh plus CEA, gap 1:6 mesh plus CEA, and 1:3 mesh were compared at 3, 6, and 12 months using extensibility, viscoelasticity, color, and transepidermal water loss by a generalized estimating equation (GEE) or generalized linear mixed model (GLMM). No significant differences were observed among the paired treatments at any time point. At 6 and 12 months, over 1:6 mesh plus CEA achieved significantly better expert evaluation scores by the Vancouver and Manchester Scar Scales (p < 0.01). Extended skin grafting plus CEA minimizes donor resources and the quality of scars is equal or similar to that with conventional low extended mesh slit-thickness skin grafting such as 1:3 mesh. A longitudinal analysis of scars may further clarify the molecular changes of scar formation and pathogenesis.

Keywords: assessment of scar quality; cultured epithelial autografts (CEA); generalized estimating equation (GEE); generalized linear mixed model (GLMM); split-thickness skin grafting.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Autografts / transplantation*
  • Cells, Cultured
  • Cicatrix / pathology
  • Dermis / pathology*
  • Dermis / transplantation*
  • Epithelial Cells / transplantation*
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Skin Transplantation*
  • Skin, Artificial*
  • Wound Healing*