Cryopreserved cultured epidermal allografts achieved early closure of wounds and reduced scar formation in deep partial-thickness burn wounds (DDB) and split-thickness skin donor sites of pediatric patients

• Published in: Burns Vol. 27; no. 7; pp. 689 - 698
• Main Authors: Yanaga, Hiroko, Udoh, Yukihiro, Yamauchi, Toshihiko, Yamamoto, Misa, Kiyokawa, Kensuke, Inoue, Yojiro, Tai, Yoshiaki
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.11.2001; Elsevier Science
• Subjects: Adolescent; Biological and medical sciences; Burn; Burns - physiopathology; Burns - surgery; Cells, Cultured; Child; Child, Preschool; Cicatrix - physiopathology; Cicatrix - prevention & control; Cryopreservation; Cultured epidermal allografts; Deep partial-thickness burn wounds; Dermatology; Epidermal Cells; Female; Humans; Infant; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Pediatric (child); Skin donor site; Skin Transplantation - methods; Time Factors; Transplantation, Homologous; Wound Healing; Burn; Deep partial-thickness burn wounds; Cryopreservation; Cultured epidermal allografts; Skin donor site; Pediatric (child); Human; Preservation; Donor site; Scar; Instrumentation therapy; Tissue culture; Homograft; Trauma; Wound; Thickness; Pathology; Histopathology; Surgery; Graft; Early; Skin; Cryoprotective agent; Technique; Child
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/S0305-4179(01)00008-0

Burn treatment in children is associated with several difficulties, e.g. available skin replacement is small, donor area could expand, and subsequent hypertrophic scar and contracture could become larger along with their physical growth. In order to have better clinical results, the authors prepared cryopreserved cultured epidermal allografts from excess epidermal cells of other patients, and applied the epidermal allografts to 55 children, i.e. 43 cases of deep partial-thickness burn wounds (DDB) due to scald burn and 12 cases with split-thickness skin donor sites. In the 43 DDB patients, epithelialization was confirmed 9.1±3.6 days (mean±S.D.) after treatment. In 10 of the 43 patients, epithelialization was comparable between the area which received the epidermal allografts (grafted area) and the area which did not receive the epidermal allografts but was covered with usual wound dressing (non-grafted area). As a result, epithelialization day was 7.9±1.7 in grafted areas and 20.5±2.3 in non-grafted areas. In the 12 patients with split-thickness skin donor sites, epithelialization was confirmed 6.3±0.9 days after treatment. Epithelialization of the grafted and non-grafted areas was comparable in 8 of the 12 patients, and it was 6.5±1.1 days and 14.1±1.6 days, respectively. In these 10 DDB patients and 8 split-thickness skin donor site patients, redness and scar formation were also milder in the grafted area. The 55 patients have been followed up for 1–8 years (mean, 4.75 years), and scar formation was suppressed in both DDB and split-thickness skin donor sites. These findings showed that cryopreserved cultured epidermal allografts achieve early closure of the wounds and good functional outcomes.