Cultured Epithelial Autografts: Skin Regeneration and Wound Healing. A Long-Term Biospy Study

Research output: Contribution to journalArticle

Abstract

In an 8-year study of 35 patients treated with cultured epithelial autografts (CEA) grafted to fullthickness burn wounds excised to muscle fascia, overall take rates of CEA averaged 55-60%. Biopsies of successfully engrafted CEA were analyzed by light microscopic, immunohistochemical, morphometric, electron microscopic and ultrastructural immunolabelling techniques in order to study skin regeneration and wound healing in these patients. Controls consisted of both normal site-and age-matched skin and healed meshed split-thickness autograft (MSTA) interstices on the same patient biopsied at comparable postgrafting time points. Key events in the regeneration of skin from CEA can be summarized as follows: At transplantation, CEA are undifferentiated and lack both granular and cornified cell layers. By 6 days postgrafting, CEA differentiate all normal epidermal strata but lack rete ridges. De novo formation of a confluent basal lamina and mature hemidesmosomes is completed by about 3 weeks. Anchoring fibrils are sparse and morphologically immature compared to normal skin until about 6-12 months postgrafting, but their maturation rate is identical to that of MSTA interstice controls. Hyperproliferation of the newly differentiated epidermis as judged by increased numbers of Ki67-positive (i.e., cycling) cells within the basal layer continues for 4-6 months after grafting. Expression of hyperproliferative keratins (cytokeratins 6/16) continues throughout the first postgrafting year and may be seen up to two years after transplantation. The site-specific phenotype of the donor skin from which the cultures are grown is reexpressed by the CEA shortly after transprantation and is maintained long-term. CEA develop rete ridges and a neodermis with normal stromal and vascular organization at about 6-12 months, whereas MSTA interstice controls do not. At 4-5 years, elastin expression is also observed in the CEA neodermis, completing the dermal regeneration process. Normal epidermal differentiation is maintained long-term, and no epidermal atypia, dysplasia or atrophy is observed. The long-term results indicate that CEA regenerate a stable normal epidermis and are capable of inducing dermal regeneration from immature wound bed connective tissue. More recent studies on 10 patients in which CEA were transplanted to engrafted, cryopreserved homograft dermis instead of granulation tissue showed increased take rates of CEA (average 85-90%) and acceleration of rete ridge formation and normalization of keratin programs within the differentiated epidermis on histological examination.

Original languageEnglish (US)
Pages (from-to)148-159
Number of pages12
JournalSkin Research
Volume38
Issue number1
DOIs
StatePublished - 1996
Externally publishedYes

Fingerprint

Autografts
Wound Healing
Regeneration
Skin
Keratin-6
Epidermis
Keratin-16
Transplantation
Hemidesmosomes
Granulation Tissue
Elastin
Fascia
Wounds and Injuries
Dermis
Keratins
Basement Membrane
Connective Tissue
Atrophy
Allografts
Blood Vessels

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

Cite this

Cultured Epithelial Autografts : Skin Regeneration and Wound Healing. A Long-Term Biospy Study. / Compton, Carolyn.

In: Skin Research, Vol. 38, No. 1, 1996, p. 148-159.

Research output: Contribution to journalArticle

@article{92970f208a7d4b4eaef50f9f971ad8b1,
title = "Cultured Epithelial Autografts: Skin Regeneration and Wound Healing. A Long-Term Biospy Study",
abstract = "In an 8-year study of 35 patients treated with cultured epithelial autografts (CEA) grafted to fullthickness burn wounds excised to muscle fascia, overall take rates of CEA averaged 55-60{\%}. Biopsies of successfully engrafted CEA were analyzed by light microscopic, immunohistochemical, morphometric, electron microscopic and ultrastructural immunolabelling techniques in order to study skin regeneration and wound healing in these patients. Controls consisted of both normal site-and age-matched skin and healed meshed split-thickness autograft (MSTA) interstices on the same patient biopsied at comparable postgrafting time points. Key events in the regeneration of skin from CEA can be summarized as follows: At transplantation, CEA are undifferentiated and lack both granular and cornified cell layers. By 6 days postgrafting, CEA differentiate all normal epidermal strata but lack rete ridges. De novo formation of a confluent basal lamina and mature hemidesmosomes is completed by about 3 weeks. Anchoring fibrils are sparse and morphologically immature compared to normal skin until about 6-12 months postgrafting, but their maturation rate is identical to that of MSTA interstice controls. Hyperproliferation of the newly differentiated epidermis as judged by increased numbers of Ki67-positive (i.e., cycling) cells within the basal layer continues for 4-6 months after grafting. Expression of hyperproliferative keratins (cytokeratins 6/16) continues throughout the first postgrafting year and may be seen up to two years after transplantation. The site-specific phenotype of the donor skin from which the cultures are grown is reexpressed by the CEA shortly after transprantation and is maintained long-term. CEA develop rete ridges and a neodermis with normal stromal and vascular organization at about 6-12 months, whereas MSTA interstice controls do not. At 4-5 years, elastin expression is also observed in the CEA neodermis, completing the dermal regeneration process. Normal epidermal differentiation is maintained long-term, and no epidermal atypia, dysplasia or atrophy is observed. The long-term results indicate that CEA regenerate a stable normal epidermis and are capable of inducing dermal regeneration from immature wound bed connective tissue. More recent studies on 10 patients in which CEA were transplanted to engrafted, cryopreserved homograft dermis instead of granulation tissue showed increased take rates of CEA (average 85-90{\%}) and acceleration of rete ridge formation and normalization of keratin programs within the differentiated epidermis on histological examination.",
author = "Carolyn Compton",
year = "1996",
doi = "10.11340/skinresearch1959.38.148",
language = "English (US)",
volume = "38",
pages = "148--159",
journal = "Skin Research",
issn = "1347-1813",
publisher = "Osaka University Medical School",
number = "1",

}

TY - JOUR

T1 - Cultured Epithelial Autografts

T2 - Skin Regeneration and Wound Healing. A Long-Term Biospy Study

AU - Compton, Carolyn

PY - 1996

Y1 - 1996

N2 - In an 8-year study of 35 patients treated with cultured epithelial autografts (CEA) grafted to fullthickness burn wounds excised to muscle fascia, overall take rates of CEA averaged 55-60%. Biopsies of successfully engrafted CEA were analyzed by light microscopic, immunohistochemical, morphometric, electron microscopic and ultrastructural immunolabelling techniques in order to study skin regeneration and wound healing in these patients. Controls consisted of both normal site-and age-matched skin and healed meshed split-thickness autograft (MSTA) interstices on the same patient biopsied at comparable postgrafting time points. Key events in the regeneration of skin from CEA can be summarized as follows: At transplantation, CEA are undifferentiated and lack both granular and cornified cell layers. By 6 days postgrafting, CEA differentiate all normal epidermal strata but lack rete ridges. De novo formation of a confluent basal lamina and mature hemidesmosomes is completed by about 3 weeks. Anchoring fibrils are sparse and morphologically immature compared to normal skin until about 6-12 months postgrafting, but their maturation rate is identical to that of MSTA interstice controls. Hyperproliferation of the newly differentiated epidermis as judged by increased numbers of Ki67-positive (i.e., cycling) cells within the basal layer continues for 4-6 months after grafting. Expression of hyperproliferative keratins (cytokeratins 6/16) continues throughout the first postgrafting year and may be seen up to two years after transplantation. The site-specific phenotype of the donor skin from which the cultures are grown is reexpressed by the CEA shortly after transprantation and is maintained long-term. CEA develop rete ridges and a neodermis with normal stromal and vascular organization at about 6-12 months, whereas MSTA interstice controls do not. At 4-5 years, elastin expression is also observed in the CEA neodermis, completing the dermal regeneration process. Normal epidermal differentiation is maintained long-term, and no epidermal atypia, dysplasia or atrophy is observed. The long-term results indicate that CEA regenerate a stable normal epidermis and are capable of inducing dermal regeneration from immature wound bed connective tissue. More recent studies on 10 patients in which CEA were transplanted to engrafted, cryopreserved homograft dermis instead of granulation tissue showed increased take rates of CEA (average 85-90%) and acceleration of rete ridge formation and normalization of keratin programs within the differentiated epidermis on histological examination.

AB - In an 8-year study of 35 patients treated with cultured epithelial autografts (CEA) grafted to fullthickness burn wounds excised to muscle fascia, overall take rates of CEA averaged 55-60%. Biopsies of successfully engrafted CEA were analyzed by light microscopic, immunohistochemical, morphometric, electron microscopic and ultrastructural immunolabelling techniques in order to study skin regeneration and wound healing in these patients. Controls consisted of both normal site-and age-matched skin and healed meshed split-thickness autograft (MSTA) interstices on the same patient biopsied at comparable postgrafting time points. Key events in the regeneration of skin from CEA can be summarized as follows: At transplantation, CEA are undifferentiated and lack both granular and cornified cell layers. By 6 days postgrafting, CEA differentiate all normal epidermal strata but lack rete ridges. De novo formation of a confluent basal lamina and mature hemidesmosomes is completed by about 3 weeks. Anchoring fibrils are sparse and morphologically immature compared to normal skin until about 6-12 months postgrafting, but their maturation rate is identical to that of MSTA interstice controls. Hyperproliferation of the newly differentiated epidermis as judged by increased numbers of Ki67-positive (i.e., cycling) cells within the basal layer continues for 4-6 months after grafting. Expression of hyperproliferative keratins (cytokeratins 6/16) continues throughout the first postgrafting year and may be seen up to two years after transplantation. The site-specific phenotype of the donor skin from which the cultures are grown is reexpressed by the CEA shortly after transprantation and is maintained long-term. CEA develop rete ridges and a neodermis with normal stromal and vascular organization at about 6-12 months, whereas MSTA interstice controls do not. At 4-5 years, elastin expression is also observed in the CEA neodermis, completing the dermal regeneration process. Normal epidermal differentiation is maintained long-term, and no epidermal atypia, dysplasia or atrophy is observed. The long-term results indicate that CEA regenerate a stable normal epidermis and are capable of inducing dermal regeneration from immature wound bed connective tissue. More recent studies on 10 patients in which CEA were transplanted to engrafted, cryopreserved homograft dermis instead of granulation tissue showed increased take rates of CEA (average 85-90%) and acceleration of rete ridge formation and normalization of keratin programs within the differentiated epidermis on histological examination.

UR - http://www.scopus.com/inward/record.url?scp=85024454884&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85024454884&partnerID=8YFLogxK

U2 - 10.11340/skinresearch1959.38.148

DO - 10.11340/skinresearch1959.38.148

M3 - Article

AN - SCOPUS:85024454884

VL - 38

SP - 148

EP - 159

JO - Skin Research

JF - Skin Research

SN - 1347-1813

IS - 1

ER -