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Novel Application of Cultured Epithelial Autografts (CEA) with Expanded Mesh Skin Grafting Over an Artificial Dermis or Dermal Wound Bed Preparation.

Sadanori Akita | Kenji Hayashida | Hiroshi Yoshimoto | Masaki Fujioka | Chikako Senju | Shin Morooka | Gozo Nishimura | Nobuhiko Mukae | Kazuo Kobayashi | Kuniaki Anraku | Ryuichi Murakami | Akiyoshi Hirano | Masao Oishi | Shintaro Ikenoya | Nobuyuki Amano | Hiroshi Nakagawa | Nagasaki University plastic surgeons group
International journal of molecular sciences | 2017

Cultured epithelial autografts (CEA) with highly expanded mesh skin grafts were used for extensive adult burns covering more than 30% of the total body surface area. A prospective study on eight patients assessed subjective and objective findings up to a 12-month follow-up. The results of wound healing for over 1:6 mesh plus CEA, gap 1:6 mesh plus CEA, and 1:3 mesh were compared at 3, 6, and 12 months using extensibility, viscoelasticity, color, and transepidermal water loss by a generalized estimating equation (GEE) or generalized linear mixed model (GLMM). No significant differences were observed among the paired treatments at any time point. At 6 and 12 months, over 1:6 mesh plus CEA achieved significantly better expert evaluation scores by the Vancouver and Manchester Scar Scales (p < 0.01). Extended skin grafting plus CEA minimizes donor resources and the quality of scars is equal or similar to that with conventional low extended mesh slit-thickness skin grafting such as 1:3 mesh. A longitudinal analysis of scars may further clarify the molecular changes of scar formation and pathogenesis.

Pubmed ID: 29295606

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