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Neiman A, Eshkol-Yogev I, Keren A, Foox M, Pinkas O, Goldstein N, Gilhar A, Zilberman M, Ullmann Y. Closure of Long Surgical Incisions with Hemostatic Tissue Adhesive in a Porcine Skin Model. Adv Skin Wound Care 2023; 36:1-10. [PMID: 37729169 DOI: 10.1097/asw.0000000000000036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
OBJECTIVE Skin adhesives offer many advantages over traditional wound-closure devices. Recently, the current research group reported on tissue adhesives composed of natural polymers (gelatin and alginate), which are biocompatible with mechanical properties suitable for tissue adhesion. The objective of the present study was to conduct clinical and histologic assessment of this hemostatic bioadhesive in the healing of long skin incisions (≥4 cm) in comparison with traditional and commercially available methods. METHODS Researchers created 24 long incisions on the ventral side of two domestic pigs to compare four different treatment modalities: two topical bioadhesives based on gelatin and alginate combined with the hemostatic agent kaolin, nylon sutures, and commercial tissue adhesive N-butyl-2-cyanoacrylate. The bioadhesive compounds were spread on the incision surface and then mixed either manually or with a double-headed syringe. After 14 days, clinical and histologic measurements were performed to evaluate the healing phase of the wounds. RESULTS The bioadhesive formulation that contained a relatively low crosslinker concentration demonstrated superior results to the formulation that contained a standard crosslinker concentration. However, no significant statistical differences were observed compared with the control incisions (sutures and commercial adhesive N-butyl-2-cyanoacrylate). This was verified by immunohistochemical analysis for epithelial integrity and scar formation as well as by clinical assessment. CONCLUSIONS This newly developed bioadhesive demonstrated suitable properties for the closure of long incisions in a porcine skin model.
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Affiliation(s)
- Ariel Neiman
- Ariel Neiman, MD, is Attending Plastic Surgeon and Head of Breast Reconstruction and Microsurgery, Meir Health Center, Kfar Saba, Israel. Inbar Eshkol-Yogev, DMD, PhD, is Clinical Lecturer, Eastman Dental Institute, UCL, London, UK. Aviad Keren, PhD, is Lab Manager, Israel Institute of Technology, Haifa. Maytal Foox, PhD, is Director of Food Technology and Product Development, Aleph Farms, Rehovot, Israel. Oded Pinkas, PhD, is Director of Process Development, NanoGhost, Netanya, Israel. Nyra Goldstein, BSc, is Researcher, Biond Biologics, Misgave Industrial Park, Israel. Also at Israel Institute of Technology, Amos Gilhar, MD, is Director, Skin Research Laboratory, Ruth & Bruce Rappaport Faculty of Medicine. Meital Zilberman, PhD, is Professor of Biomedical Engineering, Tel-Aviv University. Yehuda Ullmann, MD, is Director of the Surgical Division, Rambam Health Care Campus, Haifa
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Matsumine H, Giatsidis G, Osada A, Kamei W, Fujimaki H, Tsukamoto Y, Hashimoto K, Fujii K, Sakurai H. Keratinocyte sheets prepared with temperature-responsive dishes show enhanced survival after in vivo grafting on acellular dermal matrices in a rat model of staged bi-layered skin reconstruction. Regen Ther 2019; 11:167-175. [PMID: 31388519 PMCID: PMC6669809 DOI: 10.1016/j.reth.2019.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/20/2019] [Accepted: 07/13/2019] [Indexed: 12/17/2022] Open
Abstract
Introduction Bi-layered skin reconstruction can be achieved by staged grafting of acellular dermal matrices (ADMs) and cultured epithelial keratinocyte sheets (KSs). Both KSs and ADMs have been used for long; yet, their combined use has shown poor effectiveness. This outcome has been related to the enzymatic treatment used in the preparation of KSs, which impairs their adhesion potential to ADMs and the formation of a basement membrane (BM). Temperature-responsive (TR) culture dishes allow for enzyme-free preparation of KSs with preservation of BMs and intercellular adhesion proteins; yet, their use has not been previously applied to staged bi-layered skin reconstruction. Using an in vivo rat model, we tested the hypothesis that TR cultures enhance KSs survival and BM preservation after sequential grafting on ADMs. Methods In nude rats (n = 9/group), a 9-cm [2] full-thickness dorsal skin defect was repaired with a commercial ADM. At 2 weeks after surgery, we grafted the ADM with KSs (circular, 25 mm diameter), prepared from human cells either by enzymatic Dispase treatment (DT control group) or a TR culture dish (TR experimental group). KSs survival and BMs preservation was assessed one week later by digital imaging, histology (hematoxylin & eosin), immunohistochemistry (collagen IV, pancytokeratins) and immunofluorescence (cytokeratin 1-5-6, laminin). Results The TR group showed a significantly higher KSs survival (120 ± 49 vs. 63 ± 42 mm2; p < 0.05) and epidermal thickness (165 ± 79 vs. 65 ± 54 μm; p < 0.01) compared with the control DT group, as well as higher epidermal maturation (cytokeratin) and a denser laminin and Collagen IV expression in the BMs in vitro and in vivo. Conclusion These findings suggest that KSs prepared with TR culture dishes have significantly enhanced survival when grafted on ADMs; these outcomes could help improve current clinical strategies in wound care by skin reconstruction.
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Affiliation(s)
- Hajime Matsumine
- Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Giorgio Giatsidis
- The Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Atsuyoshi Osada
- Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Wataru Kamei
- Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Hiroshi Fujimaki
- Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Yasuhiro Tsukamoto
- Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Kazuki Hashimoto
- Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Kaori Fujii
- Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
| | - Hiroyuki Sakurai
- Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
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Maver T, Maver U, Kleinschek KS, Raščan IM, Smrke DM. Advanced therapies of skin injuries. Wien Klin Wochenschr 2015; 127 Suppl 5:S187-98. [PMID: 26404739 DOI: 10.1007/s00508-015-0859-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 08/21/2015] [Indexed: 11/24/2022]
Abstract
The loss of tissue is still one of the most challenging problems in healthcare. Efficient laboratory expansion of skin tissue to reproduce the skins barrier function can make the difference between life and death for patients with extensive full-thickness burns, chronic wounds, or genetic disorders such as bullous conditions. This engineering has been initiated based on the acute need in the 1980s and today, tissue-engineered skin is the reality. The human skin equivalents are available not only as models for permeation and toxicity screening, but are frequently applied in vivo as clinical skin substitutes. This review aims to introduce the most important recent development in the extensive field of tissue engineering and to describe already approved, commercially available skin substitutes in clinical use.
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Affiliation(s)
- Tina Maver
- Faculty of Mechanical Engineering, Laboratory for Characterisation and Processing of Polymers, University of Maribor, Smetanova 17, 2000, Maribor, Slovenia
| | - Uroš Maver
- Faculty of Medicine, Department of Pharmacology and Experimental Toxicology, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia.
| | - Karin Stana Kleinschek
- Faculty of Mechanical Engineering, Laboratory for Characterisation and Processing of Polymers, University of Maribor, Smetanova 17, 2000, Maribor, Slovenia
| | - Irena Mlinarič Raščan
- Faculty of Pharmacy, University of Ljubljana, Aškerčeva 7, 1000, Ljubljana, Slovenia
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Clinical application of cultured epithelial autografts on acellular dermal matrices in the treatment of extended burn injuries. Ann Plast Surg 2015; 73:509-15. [PMID: 24322642 DOI: 10.1097/sap.0b013e3182840883] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Achieving permanent replacement of skin in extensive full-thickness and deep partial-thickness burn injuries and chronic wounds remains one of the fundamental surgical problems. Presently, split-thickness skin grafts are still considered the best material for surgical repair of an excised burn wound. However, in burns that affect greater than 50% of total body surface area, the patient has insufficient areas of unaffected skin from which split-thickness skin grafts can be harvested. The use of cultured epithelial (or epidermal) autografts (CEAs) has achieved satisfactory results. But the take rate of CEAs is poor in full-thickness bed or in chronically infected area. Providing temporary cover with allograft skin, or a more permanent allodermis, may increase clinical take. This review aims to (1) describe the use of CEAs in the regeneration of the epidermis, (2) introduce the application of the acellular dermal matrices (ADMs) in the clinics, and (3) enhance understanding of the CEAs applied with ADM as an appropriate strategy to treat the extended burn injuries. The current evidence regarding the cultured epithelial cell or keratinocyte autograft and dermal grafts applied in the treatment of burn injuries was investigated with an extensive electronic and manual search (MEDLINE and EMBASE). The included literature (N=136 publications) was critically evaluated focusing on the efficacy and safety of this technique in improving the healing of the deep dermal and full-thickness burn injuries. This review concluded that the use of ADM with CEAs is becoming increasingly routine, particularly as a life-saving tool after acute thermal trauma.
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Evaluation of human amniotic membrane as a wound dressing for split-thickness skin-graft donor sites. BIOMED RESEARCH INTERNATIONAL 2014; 2014:572183. [PMID: 25003117 PMCID: PMC4070483 DOI: 10.1155/2014/572183] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 04/24/2014] [Accepted: 05/12/2014] [Indexed: 12/22/2022]
Abstract
Human amniotic membrane (HAM) has been used as a biomaterial in various surgical procedures and exceeds some qualities of common materials. We evaluated HAM as wound dressing for split-thickness skin-graft (STSG) donor sites in a swine model (Part A) and a clinical trial (Part B). Part A: STSG donor sites in 4 piglets were treated with HAM or a clinically used conventional polyurethane (PU) foil (n = 8 each). Biopsies were taken on days 5, 7, 10, 20, 40, and 60 and investigated immunohistochemically for alpha-smooth muscle actin (αSMA: wound contraction marker), von Willebrand factor (vWF: angiogenesis), Ki-67 (cell proliferation), and laminin (basement membrane integrity). Part B: STSG donor sites in 45 adult patients (16 female/29 male) were treated with HAM covered by PU foam, solely by PU foam, or PU foil/paraffin gauze (n = 15 each). Part A revealed no difference in the rate of wound closure between groups. HAM showed improved esthetic results and inhibitory effects on cicatrization. Angioneogenesis was reduced, and basement membrane formation was accelerated in HAM group. Part B: no difference in re-epithelialization/infection rate was found. HAM caused less ichor exudation and less pruritus. HAM has no relevant advantage over conventional dressings but might be a cost-effective alternative.
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Lee H. Outcomes of sprayed cultured epithelial autografts for full-thickness wounds: A single-centre experience. Burns 2012; 38:931-6. [DOI: 10.1016/j.burns.2012.01.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 01/18/2012] [Accepted: 01/30/2012] [Indexed: 11/30/2022]
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Loeffelbein DJ, Baumann C, Stoeckelhuber M, Hasler R, Mücke T, Steinsträßer L, Drecoll E, Wolff KD, Kesting MR. Amniotic membrane as part of a skin substitute for full-thickness wounds: an experimental evaluation in a porcine model. J Biomed Mater Res B Appl Biomater 2012; 100:1245-56. [PMID: 22576967 DOI: 10.1002/jbm.b.32689] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 10/28/2011] [Accepted: 12/01/2011] [Indexed: 12/21/2022]
Abstract
BACKGROUND We evaluated the use of human amniotic membrane (HAM) as a graft material for the treatment of iatrogenic full-thickness (FT) skin wounds in a porcine model with a view to reducing donor site morbidity in free flap transfer. METHODS Forty experimental FT-wounds were covered with an autologous split-thickness skin graft (STSG) alone or in combination with a mono- or multilayer HAM or Integra(®). Untreated wounds served as controls. Clinical evaluation and biopsy-sampling for histological and immunohistochemical staining with von-Willebrand-factor (vWF) antibody, laminin antibody, Ki-67 antibody, and smooth muscle actin (αSMA) antibody were performed on days 5, 7, 10, 20, 40, and 60 after surgical intervention. RESULTS Considerable disparities in the estimated criteria were observed between the various treatment groups of the FT-wounds. The use of HAM was found to have an accelerating impact on re-epithelialization. The multilayered amnion membrane showed better results than the Integra(®) and monolayer technique in terms of contraction rate, inflammation, and scarring and seemed useful as a dermal substitute in FT-wounds giving comparable results to STSG coverage alone. CONCLUSIONS This study demonstrates the successful application of HAM as part of a skin substitute in FT-wounds in minipigs. The results offer promise as a simple and effective technique for the application of multilayer HAM in iatrogenic human skin defects and the acceleration of wound healing.
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Affiliation(s)
- Denys J Loeffelbein
- Department of Oral and Maxillofacial Surgery, Technische Universität München, München, Germany.
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Shevchenko RV, James SL, James SE. A review of tissue-engineered skin bioconstructs available for skin reconstruction. J R Soc Interface 2009; 7:229-58. [PMID: 19864266 DOI: 10.1098/rsif.2009.0403] [Citation(s) in RCA: 414] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Situations where normal autografts cannot be used to replace damaged skin often lead to a greater risk of mortality, prolonged hospital stay and increased expenditure for the National Health Service. There is a substantial need for tissue-engineered skin bioconstructs and research is active in this field. Significant progress has been made over the years in the development and clinical use of bioengineered components of the various skin layers. Off-the-shelf availability of such constructs, or production of sufficient quantities of biological materials to aid rapid wound closure, are often the only means to help patients with major skin loss. The aim of this review is to describe those materials already commercially available for clinical use as well as to give a short insight to those under development. It seeks to provide skin scientists/tissue engineers with the information required to not only develop in vitro models of skin, but to move closer to achieving the ultimate goal of an off-the-shelf, complete full-thickness skin replacement.
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Affiliation(s)
- Rostislav V Shevchenko
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton BN2 4GJ, UK.
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Johnen C, Steffen I, Beichelt D, Bräutigam K, Witascheck T, Toman N, Moser V, Ottomann C, Hartmann B, Gerlach JC. Culture of subconfluent human fibroblasts and keratinocytes using biodegradable transfer membranes. Burns 2008; 34:655-63. [PMID: 18226463 DOI: 10.1016/j.burns.2007.08.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2006] [Accepted: 08/28/2007] [Indexed: 11/24/2022]
Abstract
This study aims to assess the suitability of biodegradable membranes as transfer matrix materials for the culture of subconfluent fibroblasts and keratinocytes. The materials investigated were based on collagen, chitosan and enzyme-digestible cellulose. The proliferation and growth behaviour of human keratinocytes and dermal fibroblasts were analysed and morphology and distribution determined. Cultured fibroblasts exhibited no significant differences in proliferation for the different membrane types, whereas keratinocytes revealed significantly higher proliferation on collagen membranes compared with membranes based on cellulose and chitosan. Co-cultured fibroblasts and keratinocytes from the same donor on collagen membranes showed more homogenous cell distribution, but they segregated in heterologous co-cultures; this effect must be further investigated. Thus, collagen and collagen-coated chitosan membranes are suitable for the subconfluent transfer of human fibroblasts and keratinocytes.
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Affiliation(s)
- C Johnen
- Charité, Campus Virchow-Clinic, Department of Surgery, Universitätsmedizin Berlin, Germany.
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Mazlyzam AL, Aminuddin BS, Fuzina NH, Norhayati MM, Fauziah O, Isa MR, Saim L, Ruszymah BHI. Reconstruction of living bilayer human skin equivalent utilizing human fibrin as a scaffold. Burns 2007; 33:355-63. [PMID: 17321690 DOI: 10.1016/j.burns.2006.08.022] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2006] [Accepted: 08/05/2006] [Indexed: 11/20/2022]
Abstract
Our aim of this study was to develop a new methodology for constructing a bilayer human skin equivalent to create a more clinical compliance skin graft composite for the treatment of various skin defects. We utilized human plasma derived fibrin as the scaffold for the development of a living bilayer human skin equivalent: fibrin-fibroblast and fibrin-keratinocyte (B-FF/FK SE). Skin cells from six consented patients were culture-expanded to passage 1. For B-FF/FK SE formation, human fibroblasts were embedded in human fibrin matrix and subsequently another layer of human keratinocytes in human fibrin matrix was stacked on top. The B-FF/FK SE was then transplanted to athymic mice model for 4 weeks to evaluate its regeneration and clinical performance. The in vivo B-FF/FK SE has similar properties as native human skin by histological analysis and expression of basal Keratin 14 gene in the epidermal layer and Collagen type I gene in the dermal layer. Electron microscopy analysis of in vivo B-FF/FK SE showed well-formed and continuous epidermal-dermal junction. We have successfully developed a technique to engineer living bilayer human skin equivalent using human fibrin matrix. The utilization of culture-expanded human skin cells and fibrin matrix from human blood will allow a fully autologous human skin equivalent construction.
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Affiliation(s)
- A L Mazlyzam
- Department of Physiology, Faculty of Medicine, UKM, Malaysia; Tissue Engineering Laboratory, HUKM, Malaysia
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Bayram Y, Deveci M, Imirzalioglu N, Soysal Y, Sengezer M. The cell based dressing with living allogenic keratinocytes in the treatment of foot ulcers: a case study. ACTA ACUST UNITED AC 2005; 58:988-96. [PMID: 16040019 DOI: 10.1016/j.bjps.2005.04.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2004] [Revised: 03/28/2005] [Accepted: 04/26/2005] [Indexed: 11/19/2022]
Abstract
In this study, we aimed to investigate the efficacy of cell based dressing with living allogenic keratinocytes in diabetic foot patients. To address this issue, the cultured keratinocytes were attached to the microcarriers produced from polyethylene and silica. The microcarriers were then applied to the wounds at 3-day intervals. Forty patients with grade II and III diabetic foot ulcers were included into the study. The patients were randomised into two groups (n=20). The treatment and control groups received cell based dressing and microcarriers kept in culture medium overnight, respectively. The wound size was recorded at 3 days intervals. The wounds were also categorised by a specific scoring system considering the wound contraction, granulation tissue formation, epithelisation and discharge from the wounds. The high score indicates better condition. The mean reduction of the wound area was 92% in the treatment group and 32% in the control group at the end of the 30 days treatment (p<0.001). When considered the complete healing, the mean number of dressings was 9.2+/-3.2 in the treatment group whereas it was 16.5+/-2.3 in the control group (p<0.001). The initial mean score of the treatment and control groups were 2.5 and 2.35, respectively. At the end of the 30th day, the mean score of the treatment group was 17.15+/-2.7 and of control group was 9.05+/-3. Allogenic keratinocyte treatment delivered with microcarriers can make significant contributions to wound healing in diabetic foot patients.
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Affiliation(s)
- Yalcin Bayram
- Department of Plastic and Reconstructive Surgery, Gülhane Military Medical Academy, Ankara, Turkey
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Abstract
Over the last 20 years, confluent sheets of cultured epithelial autograft have been used for patients with major burns. Problems with the lack of "take" and long-term durability, as well as the time delay to produce such grafts, have led to the development of delivery systems to transfer keratinocytes to the wound bed. This review article describes the problems of using cultured epithelial autograft and the advantages of using preconfluent keratinocytes. Despite the numerous delivery systems that have been reported, most studies are limited to animal wound bed models. There are a few small clinical studies that have demonstrated enhanced healing using mainly subjective methods. There is a need for controlled, randomized clinical trials to prove the efficacy of keratinocyte delivery systems. Proposals for the use of this technology are made.
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Affiliation(s)
- D L Chester
- Department of Burns and Plastic Surgery, University Hospitals Birmingham NHS Trust Selly Oak, Selly Oak, Birmingham, United Kingdom
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Moriya K, Kakizaki H, Murakumo M, Watanabe S, Chen Q, Nonomura K, Koyanagi T. Creation of luminal tissue covered with urothelium by implantation of cultured urothelial cells into the peritoneal cavity. J Urol 2004; 170:2480-5. [PMID: 14634455 DOI: 10.1097/01.ju.0000095785.89925.aa] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE We established the culture condition of seeding urothelial cells onto a scaffold for implantation into the peritoneal cavity and evaluated the histology of implanted urothelial cells. MATERIALS AND METHODS In part 1 of the study cultured porcine bladder urothelial cells were seeded onto 3 types of collagen gel made on microporous membrane, including collagen gel with or without cultured porcine bladder fibroblasts, or a feeder layer. The macroscopic and microscopic appearance of the gel with urothelial cells were examined in vitro. As an in vivo study, cultured porcine bladder urothelial cells were seeded onto a collagen gel/sponge matrix with or without cultured fibroblasts, or a feeder layer. Urothelial cell survival on each matrix was evaluated 28 days after implantation onto the omentum or mesentery of nude rats. In part 2 of the study rat urothelial cells were cultured and seeded onto fibrin gel/atelocollagen sponge matrix as an autologous implantation model. After 7 days of cultivation the matrix was folded with urothelial cells inside, implanted onto the mesentery and serially evaluated. RESULTS Gel containing cultured fibroblasts was shrunken and basement membrane formation was observed on the gel with cultured fibroblasts or the feeder layer in vitro. Urothelial cells cultured with the feeder layer better survived on the collagen based matrix and formed a hollow-like lumen when implanted into the peritoneal cavity. The regenerated urothelium in an autologous implantation showed the same histological features as normal bladder urothelium. CONCLUSIONS Selection of less degradable matrix and formation of basement membrane are critical for survival of implanted urothelial cells. The regenerated urothelium in an autologous implantation model seems to have the similar properties to the normal urothelium.
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Affiliation(s)
- Kimihiko Moriya
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
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