The importance of developing a full-thickness, 3-D replacement skin for burn victims
Skin is an amazing organ. It provides the means for us to communicate with the rest of the world and helps us make sense it. How?
Consider your appearance - how you feel when you walk into a room full of strangers, or even people you know well. Now consider how much of your self-confidence, your identity, your success and happiness in life are all wrapped up in that one large organ – the skin. How your skin looks can be as important to your well-being as what it does, which in itself is extraordinary.
Imagine what your world would be like if you couldn’t feel the touch of a loved one, the breeze playing across your face or the warmth of the sun on a spring day. And imagine if your skin couldn’t provide the protection we take for granted. It is our first line of defence against a hostile environment. Skin has the ability to defend us from the sun’s radiation, provide a barrier to bacteria and regulate our own internal environment allowing us to cool by perspiring.
All of these functions are affected by a burn: simply put, a full-thickness burn destroys the skin. Patients who do survive the trauma of a major burn will suffer painful scarring which will damage the appearance of their skin, its ability to feel and pass on information, to perspire, or to stretch and return to its normal shape. Scars don’t have the elasticity of normal skin. So imagine if you wanted to raise your hand to your face and the skin wouldn’t stretch over your joints. That’s what the future is like for a burn victim.
And that's what the newly-established Sydney Burns Foundation has set itself the challenge of changing. Led by doctors from Concord Hospital’s Burns Unit, the foundation's mission is to develop a fully-functioning replacement skin – a living skin equivalent.
To date, the most common treatment for burn wounds has been skin grafting – a surgical procedure that takes skin from a healthy part of the patient's body and transplants it to a prepared wound bed, much like transplanting a plant into a freshly prepared garden bed. As with plants there is an expected degree of graft loss with scarring and subsequent loss of integrity and function.
But now researchers have found that the cells in a skin graft carry a cellular chemical language that enables them to promote cellular activity in the wound. These interactions can be mimicked in the laboratory using state of the art techniques. At the Concord Burns Unit stem cells are harvested from the patient's own skin with the aim of producing a structure that will emulate normal skin. Stem cell cultivation and co-culturing with other materials can yield a three-dimensional living-skin replacement.. At a dedicated laboratory at the ANZAC Institute at Concord Hospital’s Campus research is ongoing to yield development and evaluation of 3 dimensional skin replacement tissue.
Building on existing good work in the field, many hours of painstaking collaborative research lie ahead. It will be expensive, which is why the foundation needs your help. The burn specialists heading the foundation aim to make the pain of survival worthwhile and give their burned patients the chance of returning to society with minimal scarring and a full life ahead of them.
Right: A normal, healthy skin providing nerves, circulation, hair follicles, sweat glands and protection from the outside world.
Left: Skin suffering burn damage, decreased cell migration, increased protease activity, altered growth and toxic mediator release.