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Karakol P, Bozkurt M, Gelbal C, Tuglu MI. Efficacy of stromal vascular fraction and enzyme-free mechanical isolation therapy in experimental full thickness burn wounds. J Plast Surg Hand Surg 2023; 57:78-94. [PMID: 34709935 DOI: 10.1080/2000656x.2021.1993234] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Autologous cell suspensions obtained by a stromal vascular fraction (SVF) and enzyme-free mechanical isolation (EMI) are an alternative in the treatment of burn wounds. In this study, we aimed to investigate the effect of autologous cell suspensions obtained by SVF and EMI on full-thickness skin burn wounds. METHODS A total of 45 male Sprague-Dawley rats were divided into three groups, SVF group, EMI group, and SVF + EMI group. The groups were also classified as the first, second, and third week of the burn to reveal the effect of the treatment on the burn in the early, middle, and late stages. For treatment, 0.2 ml SVF or 0.2 ml EMI was injected subcutaneously into the burn lesions of the subjects. Histopathological examination was performed on the burn wounds taken at the end of the experiment, and Ki67, CD44, CD73, CD90, and CK17 expressions were evaluated. RESULTS Histological examination revealed that there was no improvement in the control samples, but the skin was multicellular, vascularization was present. Histologic scores in all groups was significantly better than control, and SVF + EMI was the best group in terms of recovery (p < 0.05). Ki67, CK17, CD44, CD73, and CD90 expressions were significantly higher in the treatment groups compared to the control (p < 0.05). CONCLUSION We found in our study that both applications significantly increased the healing of the burn wound. Moreover, SVF + EMI application provided more improvement than SVF or EMI alone.
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Affiliation(s)
- Percin Karakol
- Department of Plastic, Reconstructive and Aesthetic Surgery, Health Science University Bağcilar Education and Training Hospital, Istanbul, Turkey
| | - Mehmet Bozkurt
- Department of Plastic, Reconstructive and Aesthetic Surgery, Health Science University Bağcilar Education and Training Hospital, Istanbul, Turkey
| | - Caner Gelbal
- Department of Plastic, Reconstructive and Aesthetic Surgery, Health Science University Bağcilar Education and Training Hospital, Istanbul, Turkey
| | - Mehmet Ibrahim Tuglu
- Faculty of Medicine, Department of Histology, Celal Bayar University, Manisa, Turkey
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2
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Autologous Cell Harvesting System as Adjunct for Soft-tissue Reconstruction of Necrotizing Soft Tissue Infection. Plast Reconstr Surg Glob Open 2022; 10:e4197. [PMID: 35317465 PMCID: PMC8932480 DOI: 10.1097/gox.0000000000004197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 01/25/2022] [Indexed: 11/26/2022]
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Woodroof AE, Naughton GK, Wood FM, Christy RJ, Natesan S, Hickerson WL. Path to 'One and Done'. J Wound Care 2021; 30:794-802. [PMID: 34644136 DOI: 10.12968/jowc.2021.30.10.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Gail K Naughton
- Founder and Scientific Advisor, Histogen, Inc., San Diego, CA, US
| | | | - Robert J Christy
- Supervisory Research Physiologist, Cross Functional Research Team, Burn and Soft Tissue Research, US Army Institute of Surgical Research, Ft. Sam Houston, TX, US
| | - Shanmugasundaram Natesan
- Research Scientist, Cross Functional Research Team, Burn and Soft Tissue Research, US Army Institute of Surgical Research, Ft. Sam Houston, TX, US
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Rashid ST, Cavale N, Bowling FL. A pilot feasibility study of non‐cultured autologous skin cell suspension for healing diabetic foot ulcers. Wound Repair Regen 2020; 28:719-727. [DOI: 10.1111/wrr.12844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 06/17/2020] [Accepted: 06/17/2020] [Indexed: 12/27/2022]
Affiliation(s)
| | | | - Frank L. Bowling
- Manchester Royal Infirmary & University of Manchester Manchester UK
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Hayes PD, Harding KG, Johnson SM, McCollum C, Téot L, Mercer K, Russell D. A pilot multi-centre prospective randomised controlled trial of RECELL for the treatment of venous leg ulcers. Int Wound J 2020; 17:742-752. [PMID: 32103603 PMCID: PMC7217204 DOI: 10.1111/iwj.13293] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 12/06/2019] [Indexed: 11/28/2022] Open
Abstract
Venous leg ulcers (VLUs) have a significant impact on approximately 3% of the adult population worldwide, with a mean NHS wound care cost of £7600 per VLU over 12 months. The standard care for VLUs is compression therapy, with a significant number of ulcers failing to heal with this treatment, especially with wound size being a risk factor for non-healing. This multicentre, prospective, randomised trial evaluated the safety and effectiveness of autologous skin cell suspension (ASCS) combined with compression therapy compared with standard compression alone (Control) for the treatment of VLUs. Incidence of complete wound closure at 14 weeks, donor site closure, pain, Health-Related Quality of Life (HRQoL), satisfaction, and safety were assessed in 52 patients. At Week 14, VLUs treated with ASCS + compression had a statistically greater decrease in ulcer area compared with the Control (8.94 cm2 versus 1.23 cm2 , P = .0143). This finding was largely driven by ulcers >10 to 80 cm2 in size, as these ulcers had a higher mean percentage of reepithelialization at 14 weeks (ASCS + compression: 69.97% and Control: 11.07%, P = .0480). Additionally, subjects treated with ASCS + compression experienced a decrease in pain and an increase in HRQoL compared with the Control. This study indicates that application of ASCS + compression accelerates healing in large venous ulcers.
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Affiliation(s)
| | | | | | | | - Luc Téot
- Lapeyronie Health FacilityMontpellierFrance
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Holmes Iv JH, Molnar JA, Carter JE, Hwang J, Cairns BA, King BT, Smith DJ, Cruse CW, Foster KN, Peck MD, Sood R, Feldman MJ, Jordan MH, Mozingo DW, Greenhalgh DG, Palmieri TL, Griswold JA, Dissanaike S, Hickerson WL. A Comparative Study of the ReCell® Device and Autologous Spit-Thickness Meshed Skin Graft in the Treatment of Acute Burn Injuries. J Burn Care Res 2020; 39:694-702. [PMID: 29800234 PMCID: PMC6097595 DOI: 10.1093/jbcr/iry029] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Early excision and autografting are standard care for deeper burns. However, donor sites are a source of significant morbidity. To address this, the ReCell® Autologous Cell Harvesting Device (ReCell) was designed for use at the point-of-care to prepare a noncultured, autologous skin cell suspension (ASCS) capable of epidermal regeneration using minimal donor skin. A prospective study was conducted to evaluate the clinical performance of ReCell vs meshed split-thickness skin grafts (STSG, Control) for the treatment of deep partial-thickness burns. Effectiveness measures were assessed to 1 year for both ASCS and Control treatment sites and donor sites, including the incidence of healing, scarring, and pain. At 4 weeks, 98% of the ASCS-treated sites were healed compared with 100% of the Controls. Pain and assessments of scarring at the treatment sites were reported to be similar between groups. Significant differences were observed between ReCell and Control donor sites. The mean ReCell donor area was approximately 40 times smaller than that of the Control (P < .0001), and after 1 week, significantly more ReCell donor sites were healed than Controls (P = .04). Over the first 16 weeks, patients reported significantly less pain at the ReCell donor sites compared with Controls (P ≤ .05 at each time point). Long-term patients reported higher satisfaction with ReCell donor site outcomes compared with the Controls. This study provides evidence that the treatment of deep partial-thickness burns with ASCS results in comparable healing, with significantly reduced donor site size and pain and improved appearance relative to STSG.
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Affiliation(s)
| | - Joseph A Molnar
- Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | | | - James Hwang
- University of Alabama-Birmingham, Birmingham, Alabama
| | - Bruce A Cairns
- University of North Carolina, Chapel Hill, North Carolina
| | - Booker T King
- U.S. Army Institute for Surgical Research, Fort Sam Houston, Texas
| | | | | | | | - Michael D Peck
- Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - Rajiv Sood
- University of Indiana, Indianapolis, Indiana
| | - Michael J Feldman
- Virginia Commonwealth University, Richmond, Virginia Commonwealth University, Richmond, Virginia
| | - Marion H Jordan
- MedStar Washington Hospital Center, Washington, District of Columbia
| | | | | | | | - John A Griswold
- Texas Tech University Health Sciences Center, Lubbock, Texas
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Manning L, Hamilton EJ, Raby E, Norman PE, Davis W, Wood F, Carville K, Baba M, Hiew J, Ryan E, Ferreira I, Gittings P, Ritter JC. Spray on skin for diabetic foot ulcers: an open label randomised controlled trial. J Foot Ankle Res 2019; 12:52. [PMID: 31788029 PMCID: PMC6858641 DOI: 10.1186/s13047-019-0362-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/30/2019] [Indexed: 12/24/2022] Open
Abstract
Background One Australian loses a limb every 3 h as a result of infected diabetic foot ulcers (DFU). This common condition accounts for substantial morbidity and mortality for affected individuals and heavy economic costs for the health sector and the community. There is an urgent need to test interventions that improve wound healing time, prevent amputations and recurrent ulceration in patients presenting with DFU whilst improving quality of life and reducing health care costs. Methods One hundred and fifty eligible participants will be randomised to receive an autologous skin cell suspension, also termed 'spray-on' skin (ReCell®) or standard care interventions for their DFU. The primary outcome is complete wound healing at 6 months, but participants will be followed up for a total of 12 months to enable secondary outcomes including total overall costs, ulcer free days at 12 months and quality of life to be assessed. Discussion Outpatient costs for dressings, home nursing visits and outpatient appointments are key cost drivers for DFU. If spray-on skin is effective, large cost savings to WA Health will be realised immediately through a shortened time to healing, and through a higher proportion of patients achieving complete healing. Shortened healing times may enable participants to return to work earlier. Any economic benefits are likely to be amplified across Australia and other similar demographic settings where aging populations with increased diabetes rates are considered major future challenges. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618000511235. Registered on 9 April 2018.
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Affiliation(s)
- Laurens Manning
- 1Department of Infectious Diseases, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150 Australia
| | - Emma J Hamilton
- 2Endocrinology Department, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150 Australia
| | - Edward Raby
- 1Department of Infectious Diseases, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150 Australia
| | - Paul E Norman
- 3Medical School, University of Western Australia, Crawley, WA 6009 Australia.,4Department of Vascular Surgery, Fremantle Hospital, Alma Street, Fremantle, WA 6160 Australia
| | - Wendy Davis
- 3Medical School, University of Western Australia, Crawley, WA 6009 Australia
| | - Fiona Wood
- 5State Burns Unit, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150 Australia
| | - Keryln Carville
- 6Silver Chain Group and School of Nursing and Midwifery, Curtin University, Bentley, WA 6102 Australia
| | - Mendel Baba
- 7Podiatry Department, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150 Australia
| | - Jonathan Hiew
- 7Podiatry Department, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150 Australia
| | - Erica Ryan
- 7Podiatry Department, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150 Australia
| | - Ivana Ferreira
- 7Podiatry Department, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150 Australia
| | - Paul Gittings
- 8Burns Department, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150 Australia
| | - Jens C Ritter
- 9Department of Vascular Surgery, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA 6150 Australia
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Liu B, Chen HH, Liu ZH, Liang JF, Xue RJ, Chen PJ, Li CX, Liang XD, Deng J, Ye RX, Zhang XB, Liang JY. The clinical efficacy of treatment using the autologous non-cultured epidermal cell suspension technique for stable vitiligo in 41 patients. J DERMATOL TREAT 2019; 32:90-94. [PMID: 31084382 DOI: 10.1080/09546634.2019.1619657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Bin Liu
- Guangzhou New Centre Institute of Vitiligo, Guangzhou, PR China
| | - Hui-Heng Chen
- Dongguan Eighth People’s Hospital & Dongguan Children’s Hospital, Dongguan, PR China
| | - Zhong-Hai Liu
- Guangzhou New Centre Institute of Vitiligo, Guangzhou, PR China
| | - Jing-Feng Liang
- Guangzhou New Centre Institute of Vitiligo, Guangzhou, PR China
| | - Ru-Jun Xue
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, PR China
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, PR China
| | - Ping-Jiao Chen
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Chang-Xing Li
- Department of Dermatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Xiao-Dong Liang
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, PR China
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, PR China
| | - Jie Deng
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, PR China
| | - Rui-Xian Ye
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, PR China
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, PR China
| | - Xi-Bao Zhang
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, PR China
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, PR China
| | - Jing-Yao Liang
- Institute of Dermatology, Guangzhou Medical University, Guangzhou, PR China
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, PR China
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