A Pilot Study of Negative Pressure Therapy with Autologous Skin Cell Suspensions in a Porcine Model

• Published in: The Journal of surgical research 2021-11, Vol.267, p.182-196
• Main Authors: Carney, Bonnie C., Moffatt, Lauren T., Travis, Taryn E., Nisar, Saira, Keyloun, John W., Prindeze, Nicholas J., Oliver, Mary A., Kirkpatrick, Liam D., Shupp, Jeffrey W.
• Format: Article
• Language: English
• Subjects: Autologous skin cell suspension (ASCS); Burn wounds, Duroc pig; Meshed split thickness skin grafting; Negative pressure wound therapy (NPWT); RECELL system
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2021.05.010

•Autologous skin cell suspensions can be used in combination with negative pressure wound therapy.•There are no negative aspects to this technique when comparing to controls.•This technique improves graft adherence and elasticity of healed wounds. Negative pressure wound therapy (NPWT) is an option for securing meshed split thickness skin grafts (mSTSGs) after burn excision to optimize skin graft adherence. Recently, the use of autologous skin cell suspension (ASCS) has been approved for use in the treatment of burn injuries in conjunction with mSTSGs.To date, limited data exists regarding the impact of NPWT on healing outcomes when the cellular suspension is utilized. It was hypothesized that NPWT would not negatively impact wound healing of ASCS+mSTSG. A burn, excision, mSTSG, ASCS ± NPWT model was used. Two Duroc pigs were utilized in this experiment, each with 2 sets of paired burns. Four wounds received mSTSG+ASCS+NPWT through post-operative day 3, and 4 wounds received mSTSG+ACSC+ traditional ASCS dressings. Cellular viability was characterized prior to spraying. Percent re-epithelialization, graft-adherence, pigmentation, elasticity, and blood perfusion and blood vessel density were assessed at multiple time points through 2 weeks. All wounds healed within 14 days with minimal scar pathology and no significant differences in percent re-epithelialization between NPWT, and non-NPWT wounds were observed. Additionally, no differences were detected for pigmentation, perfusion, or blood vessel density. NPWT treated wounds had less graft loss and improved elasticity, with elasticity being statistically different. These data suggest the positive attributes of the cellular suspension delivered are retained following the application of negative pressure. Re-epithelialization, revascularization, and repigmentation are not adversely impacted. The use of NPWT may be considered as an option when using ASCS with mSTSGs for the treatment of full-thickness burns.