Burns research & reconstructive surgery

A clinical evaluation of efficacy and safety of cultured epithelial autograft (CEA) suspension applied to a donor site on a burn injured patient.

Maitz P., Kennedy P., Zhe Li , Taggart S., Leong T. and Nieuwendyk K.

A patient with severe burn injury usually needs skin grafting, a surgical procedure that involves transplanting split-skin grafts harvested from a healthy donor site to the wound area. The management of the donor site is therefore a very important issue in patient care. Rapid healing allows repeated use of the same donor site in patients with large burns. But any delay in donor-site healing could lead to complications, such as infection, and compromise the recovery process of burns patients. This study is designed to examine whether the delivery of cultured autologous keratinocytes to the donor-site wound could facilitate or speed up its healing process.

Burn patients with a donor site less than or equal to 2% total body surface area (TBSA) will be recruited to join the trial subject to informed consent. The two donor sites of each patient will be divided randomly into CEA group and control. Consenting participants will have a skin biopsy taken from which keratinocytes will be isolated and cultivated at the Skin Culture Laboratory at Concord Hospital. On operation day, the cultured keratinocytes will be harvested and spray-delivered to the donor site in the CEA group while the control site wound receive the control vehicle solution only.

Evaluation of wound healing will occur by various methods including the measurement of evaporative water loss on different days post surgery and on each dressing change until the donor site has fully reepithelialized. Data will be analysed statistically to determine the effectiveness of cultured CEA suspension in donor site healing.