The press must be working overtime in San Antonio....you just got to love comments like this comming from the top people in the burns field.
Cheers, Bent
“If the trial is successful,” Dr. James H. Holmes IV, director of Wake Forest Baptist Medical Center's burn facility, said of the technology called ReCell, “this will change the way burns are operatively managed in the United States forever.”
Revolutionary treatment for burns being tested
Hailed as a “game changer,” a new way of treating burn victims is being tested by researchers at Fort Sam Houston and across the country: Healthy skin is taken from a patient, mixed in a small kit and sprayed over damaged skin.
“If the trial is successful,” Dr. James H. Holmes IV, director of Wake Forest Baptist Medical Center's burn facility, said of the technology called ReCell, “this will change the way burns are operatively managed in the United States forever.”Experts tout ReCell as a breakthrough for treating second-degree burns, the kind suffered in fires and kitchen accidents. The process originated in Australia and has had success after use in 3,500 cases there, in Europe and Canada; but trials began only recently at the Army Institute of Surgical Research and other sites in the United States.
It's a time-saver in surgery, requiring only 20 minutes. ReCell also has other benefits over conventional methods, researchers said.
“Using traditional skin grafting techniques, we must remove a much larger amount of skin from the patient to cover a wound,” said Dr. Evan Renz, burn center director at the ISR.
“It causes a complete paradigm shift,” said Holmes, a burn surgeon. “We're able to cover 320 square centimeters of wound with four square centimeters of skin.”
Translated, that means using a piece of skin to cover a wound up to 80 times its size. Traditional skin grafts, when they can be put though a mesher, can expand to about nine times their original size.
An FDA trial under way will follow 106 patients to study the effectiveness of the ReCell kit, made by Los Angeles-based Avita Medical Americas.
It works like this: Doctors scrape off a slice of healthy skin. The cells are dipped into a heated well filled with a solution that loosens them from other tissue. Once separated, the cells are put into a second well and rinsed in saline, and then injected into another well containing a mesh strainer. The cleansed cells are then sprayed onto the damaged skin, where they start to grow immediately.
Fort Sam will study 12 patients for a year. It may be three years, however, before the FDA rules on how well ReCell works.
“It's really the kit that's being tested,” said Bryan Jordan, a senior ISR research nurse who thinks ReCell could reduce infections and help patients recover faster. “And we're looking at the process and the end results to get at that information.”
ReCell won't help victims of electrical injuries, which can cause deep burns that defy conventional treatments, said Jordan, a registered nurse.
It also isn't clear whether it can help badly burned GIs, although Dr. Evan Renz, burn center director at the ISR, said he hopes ReCell will “improve the long-term quality of life for our wounded warriors.”
The San Antonio Military Medical Center has treated more than 1,000 troops burned in Iraq and Afghanistan since 2001. Most suffer third-degree burns, which can run far deeper into the skin, through fat and into muscle.
ReCell is most effective in burns that don't run too deeply into the dermis, the second layer of skin. It isn't clear whether ReCell could help troops with more serious burns, but the Army has searched for solutions.
The Pentagon and Army have spent $85 million to fund consortiums with Wake Forest and the University of Pittsburgh's McGowan Institute for Regenerative Medicine, and Rutgers-Cleveland Clinic.
All are partners in the Armed Forces Institute of Regenerative Medicine — a group that also includes Rice University and the University of Texas Health Science Center in Houston — which has partly funded the ReCell study with a $1.4 million grant.
In business since 2008, the institute and a dozen universities have developed new products for wounded troops, one of them StrataGraft, a skin substitute that could be used in the war zone that's in the process of being tested.
StrataGraft covers a burn wound for weeks, until patients are stabilized and able to undergo a skin graft. Doctors now use ointments, creams and dressings to spare the wound from infection.
Those methods have drawbacks: They're painful to put on and take off; and transporting patients can be difficult because of the pain they endure and time required for medical teams to treat them.
Holmes said the last big development in burn care came in the early 1980s when doctors began cutting off damaged tissue one to two weeks after surgery, rather than waiting for the skin to rot off, resulting in the single-biggest reduction in mortality of anything that had come along.
“This is to burn surgery right now what cardiac stents were to cardiac surgery,” Holmes said. “I mean, it's a reduction of that amount in invasiveness.”
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