Hi AllHad a bit of a dig around and found the abstract presented...

Hi All

Had a bit of a dig around and found the abstract presented at the 2013 American Burns Assoc annual meeting held in April 2013 by Dr Greenwood. The conclusion is instructive and to help I have included a link to a wikipedia definition.

https://en.wikipedia.org/wiki/Stratified_squamous_epithelium

I`m no scientist but it all sounds pretty good.


14 . Experience with a Polymer-Based Cultured
Composite ‘Skin’ (CCS)
J. E. Greenwood, BSc(Hons), MBChB, MD,
FRCS(Eng), FRCS(Plast), FRACS, B. Dearman,
BSc, A. Li, BSc(Hons)
Royal Adelaide Hospital, Adelaide, Australia
Introduction: We have previously demonstrated that an autologous
cultured composite ‘skin’ in a porcine model could effect
definitive wound closure. The aim of this study was to verify
previous finding; that cultured composite ‘skin’ can definitively
close fresh surgical wounds and wounds into which a Biodegradable
Temporising Matrix (BTM) have been integrated.
Methods: Blood was taken from three large white x landrace domestic
pigs for autologous plasma and thrombin. Four 8x8cm
sites were designed (two on each flank). Split thickness grafts
were taken from these sites to provide autologous cellular components
for composite construction. Three deep wounds were
created to the panniculus adiposus. A sealed, 2mm thick BTM
was implanted into these deep wounds for 21 days awaiting
CCS production. For CCS Generation, a 1mm thick, unsealed
polyurethane ‘autologous plasma/thrombin-soaked’ foam was
seeded with autologous fibroblasts (at 6x104 cells/cm2) and
cultured for 5 days. Autologous keratinocytes were added to the
fibroblast-containing foam at 2.5x105 cells per cm2 and further
co-cultured. On Day 21 post-surgery, a fourth identical wound
was generated, to receive a CCS alone. At the other three sites,
the integrated BTMs were delaminated, the surface dermabraded
and CCSs applied.
Results: CCS over BTM - two phenomena were noted. (i)
CCS ‘take’ The degree of ‘take’ varied within BTM-CCS treated
wounds, in general this was observed by Day 7 post-application
with some polymer in the hyperkeratotic layer external to the
well-developed epidermis with continuous basement membrane.
By end-point at Day 31 post-CCS application, the CCS
foam had been ‘shed’ from the wound by epidermal sloughing,
leaving a robust, thick stratified epithelium. (ii) CCS as
‘Delivery Vehicle’ In some wounds, the CCS generated a thin
‘carapace’ over the wound, depositing cells. Upon removal at
Day 10, a thick epithelium had developed.
CCS only (no BTM) By Day 7, the composite foam had completely
integrated into exuberant vascular tissue. Epithelialisation
was evident as islands of epithelium at Day 10. By Day 17,
the wound was ~95% re-epithelialised, with stratified squamous
epithelium, continuous basement membrane and rete pegs. The
epithelium became more complete as time progressed in all
wound areas simultaneously.
Conclusions: The CCS generated a bilayer repair over the fresh
wound’s fatty base, and on the BTM-integrated wounds, which
consisted of dermal elements and a keratinised stratified squamous
epidermis anchored with a basement membrane by Day
7. The CCS demonstrated different behaviours, depending on
the deposition of the cells within the composite.
Applicability of Research to Practice: Second stage of a twostage
strategy to abolish the need for split skin grafts in major
burn injury.
External Funding: BioInnovation SA, PolyNovo Biomater