Clinical Results of an Autologous Engineered Skin
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Cell and Tissue Banking (2006) 7:47–53 DOI 10.1007/s10561-004-7253-4
Clinical results of an autologous engineered skin Sara Llames1, Eva Garcı´ a1, Vero´nica Garcı´ a1, Marcela del Rı´ o2, Fernando Larcher2, Jose Luis Jorcano2, Eva Lo´pez3, Purificacio´n Holguı´ n4, Francisca Miralles5, Jesu´s Otero6 and Alvaro Meana1,* 1
CCST, Asturias; 2CIEMAT, Madrid; 3Plastic surgery, Hospital Universitario la Fe, Valencia; 4Plastic surgery, Hospital Universitario de Getafe, Madrid; 5Plastic surgery, Hospital Virgen del Rocı´o, Sevilla; 6 Transplant coordinator, Hospital Central de Asturias; *Author for correspondence: Centro Comunitario de Sangre y Tejidos del Principado de Asturias, Emilio Rodriguez Vigil s/n, 33006 Oviedo, Spain (e-mail: [email protected]; phone: +34-985-23-24-26; fax: +34-985-24-00-38) Received 3 March 2004; accepted in revised form 29 November 2004
Key words: Artificial skin, Dermal scaffold, Human plasma, Keratinocyte culture, Tissue engineering
Abstract Introduction: An artificial complete skin (dermis and epidermis) model has been developed in the Tissue engineering unit of the Centro Comunitario de Sangre y Tejidos del Principado de Asturias (CCST) and CIEMAT. This engineered skin has been employed for the treatment of severe epithelial injuries. In this paper, the clinical results obtained with this engineered skin during the last 18 months were evaluated. Patients, material and methods: (a) Culture: Cells (fibroblasts and keratinocytes) were obtained from biopsies by a double enzymatic digestion. After an expansion period, fibroblasts were seeded in an artificial dermis based on human plasma. Keratinocytes were seeded over this dermal surface. (b) Patients: 20 skin biopsies were processed (13 burned patients, 5 giant nevus, 1 GVHD, 1 neurofibromatosis), which came from different hospitals across the country. About 97,525 cm2 of engineered skin were cultured. Results: The engineered skin took in all patients. The take percentage depended on previous pathology (burned patients 10–90%; non-critical patients 70–90%). The epithelization obtained was permanent in all cases. During the follow-up period, epithelial loss, blistering injuries or skin retractions were not observed. The aesthetic and functional results were acceptable. Conclusions: This artificial skin has demonstrated to be useful for the definitive treatment of patients with severe skin injuries. This work shows that it is possible to produce this prototype in an hospitalarian laboratory and distribute it to different hospitals across the country.
Introduction Skin tissue engineering techniques have improved the treatment of severe skin injuries. However, their high cost and scarce availability in Spain have limited their use. According to the Spanish law, cultured keratinocytes and other products of tissue engineering
with living human cells are considered human tissues and their production and distribution comes into the tissue bank activity. In 1994 our bank (Centro Comunitario de Sangre y Tejidos del Principado de Asturias
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