Use of an autologous bioengineered composite skin in extensive burns: Clinical and functional outcomes. A multicentric study

Abstract Objective We report clinical and functional outcomes obtained after application of an autologous bioengineered composite skin (ABCS) produced in a single Spanish tissue-engineering unit. Materials/methods Twenty-five burned patients treated with ABCS from 1999 to 2007 in five burn centres w...

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Bibliographic Details
Published in:Burns 2011-06, Vol.37 (4), p.580-589
Main Authors: Gómez, C, Galán, J.M, Torrero, V, Ferreiro, I, Pérez, D, Palao, R, Martínez, E, Llames, S, Meana, A, Holguín, P
Format: Article
Language:English
Subjects:
Adolescent
Adult
Bioengineering
Biological and medical sciences
Burns
Burns - surgery
Child
Cohort Studies
Critical Care
Cultured skin
Female
Fibroblasts - pathology
Humans
Keratinocytes - pathology
Male
Medical sciences
Middle Aged
Patient Satisfaction
Retrospective Studies
Skin substitute
Skin Transplantation - methods
Skin, Artificial
Tissue Engineering - methods
Tissue-engineered skin
Transplantation, Autologous
Traumas. Diseases due to physical agents
Young Adult
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Summary:Abstract Objective We report clinical and functional outcomes obtained after application of an autologous bioengineered composite skin (ABCS) produced in a single Spanish tissue-engineering unit. Materials/methods Twenty-five burned patients treated with ABCS from 1999 to 2007 in five burn centres were included in the study. Mean age was 29 years (SD 11), with mean total body surface area (TBSA) burned being 74% (SD 17) and mean full-thickness injury of 61% (SD 19) of TBSA. Results The mean area initially engrafted with ABCS was 24% (SD 13) of TBSA, with a final take of 49% (SD 30, range 0–100%). ABCS achieved permanent coverage of a mean of 11% (SD 8) of TBSA. In subset analyses, lack of pre- and post-application wound bed infection and lack of serious acute systemic complications at the time of engraftment were significantly associated with better ABCS take. Conclusions Final take obtained with ABCS could be improved with the use of non-cytotoxic topical antibiotics following engraftment. The use of plasma to prepare ABCS reduces production costs: cost-effectiveness ratio is not a limitation for its use. In terms of patient satisfaction, cosmetic/functional outcomes (general appearance, texture, flexibility, sensitivity and colour) of ABCS and split-thickness autografts are not different statistically.
ISSN:0305-4179
1879-1409
DOI:10.1016/j.burns.2010.10.005