Full-thickness skin wound healing using autologous keratinocytes and dermal fibroblasts with fibrin

Bilayered versus single-layered substitute

Ruszymah Idrus, Mohd Adha Bin P Rameli, Kiat Cheong Low, Jia Xian Law, Chua Kien Hui, Mazlyzam Bin Abdul Latiff, Aminuddin Bin Saim

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Split-skin grafting (SSG) is the gold standard treatment for full-thickness skin defects. For certain patients, however, an extensive skin lesion resulted in inadequacies of the donor site. Tissue engineering offers an alternative approach by using a very small portion of an individual's skin to harvest cells for propagation and biomaterials to support the cells for implantation. The objective of this study was to determine the effectiveness of autologous bilayered tissue-engineered skin (BTES) and single-layer tissue-engineered skin composed of only keratinocytes (SLTES-K) or fibroblasts (SLTES-F) as alternatives for full-thickness wound healing in a sheep model. Full-thickness skin biopsieswere harvested from adult sheep. Isolated fibroblasts were cultured using medium Ham's F12: Dulbecco modified Eagle medium supplemented with 10% fetal bovine serum, whereas the keratinocytes were cultured using Define Keratinocytes Serum Free Medium. The BTES, SLTES-K, and SLTES-F were constructed using autologous fibrin as a biomaterial. Eight full-thickness wounds were created on the dorsum of the body of the sheep. On 4 wounds, polyvinyl chloride rings were used as chambers to prevent cell migration at the edge. The wounds were observed at days 7, 14, and 21. After 3 weeks of implantation, the sheep were euthanized and the skinswere harvested. The excised tissues were fixed in formalin for histological examination via hematoxylin-eosin, Masson trichrome, and elastin van Gieson staining. The results showed that BTES, SLTES-K, and SLTES-F promote wound healing in nonchambered and chambered wounds, and BTES demonstrated the best healing potential. In conclusion, BTES proved to be an effective tissue-engineered construct that can promote the healing of full-thickness skin lesions. With the support of further clinical trials, this procedure could be an alternative to SSG for patients with partial- And full-thickness burns.

Original languageEnglish
Pages (from-to)171-180
Number of pages10
JournalAdvances in Skin and Wound Care
Volume27
Issue number4
DOIs
Publication statusPublished - 2014

Fingerprint

Fibrin
Keratinocytes
Wound Healing
Fibroblasts
Skin
Sheep
Skin Transplantation
Wounds and Injuries
Biocompatible Materials
Eagles
Elastin
Serum-Free Culture Media
Hematoxylin
Tissue Engineering
Eosine Yellowish-(YS)
Burns
Polyvinyl Chloride
Formaldehyde
Cell Movement
Tissue Donors

Keywords

  • Autologous skin substitute
  • Fibrin
  • Fibroblasts
  • Keratinocytes
  • Sheep model

ASJC Scopus subject areas

  • Advanced and Specialised Nursing
  • Dermatology

Cite this

Full-thickness skin wound healing using autologous keratinocytes and dermal fibroblasts with fibrin : Bilayered versus single-layered substitute. / Idrus, Ruszymah; Rameli, Mohd Adha Bin P; Low, Kiat Cheong; Law, Jia Xian; Kien Hui, Chua; Abdul Latiff, Mazlyzam Bin; Saim, Aminuddin Bin.

In: Advances in Skin and Wound Care, Vol. 27, No. 4, 2014, p. 171-180.

Research output: Contribution to journalArticle

Idrus, Ruszymah ; Rameli, Mohd Adha Bin P ; Low, Kiat Cheong ; Law, Jia Xian ; Kien Hui, Chua ; Abdul Latiff, Mazlyzam Bin ; Saim, Aminuddin Bin. / Full-thickness skin wound healing using autologous keratinocytes and dermal fibroblasts with fibrin : Bilayered versus single-layered substitute. In: Advances in Skin and Wound Care. 2014 ; Vol. 27, No. 4. pp. 171-180.
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abstract = "Split-skin grafting (SSG) is the gold standard treatment for full-thickness skin defects. For certain patients, however, an extensive skin lesion resulted in inadequacies of the donor site. Tissue engineering offers an alternative approach by using a very small portion of an individual's skin to harvest cells for propagation and biomaterials to support the cells for implantation. The objective of this study was to determine the effectiveness of autologous bilayered tissue-engineered skin (BTES) and single-layer tissue-engineered skin composed of only keratinocytes (SLTES-K) or fibroblasts (SLTES-F) as alternatives for full-thickness wound healing in a sheep model. Full-thickness skin biopsieswere harvested from adult sheep. Isolated fibroblasts were cultured using medium Ham's F12: Dulbecco modified Eagle medium supplemented with 10{\%} fetal bovine serum, whereas the keratinocytes were cultured using Define Keratinocytes Serum Free Medium. The BTES, SLTES-K, and SLTES-F were constructed using autologous fibrin as a biomaterial. Eight full-thickness wounds were created on the dorsum of the body of the sheep. On 4 wounds, polyvinyl chloride rings were used as chambers to prevent cell migration at the edge. The wounds were observed at days 7, 14, and 21. After 3 weeks of implantation, the sheep were euthanized and the skinswere harvested. The excised tissues were fixed in formalin for histological examination via hematoxylin-eosin, Masson trichrome, and elastin van Gieson staining. The results showed that BTES, SLTES-K, and SLTES-F promote wound healing in nonchambered and chambered wounds, and BTES demonstrated the best healing potential. In conclusion, BTES proved to be an effective tissue-engineered construct that can promote the healing of full-thickness skin lesions. With the support of further clinical trials, this procedure could be an alternative to SSG for patients with partial- And full-thickness burns.",
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