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Int. J. Mol. Sci. 2018, 19(1), 57; https://doi.org/10.3390/ijms19010057

Novel Application of Cultured Epithelial Autografts (CEA) with Expanded Mesh Skin Grafting Over an Artificial Dermis or Dermal Wound Bed Preparation

1
Department of Plastic Surgery, Wound Repair and Regeneration, School of Medicine, Fukuoka University, Fukuoka 814-0180, Japan
2
Department of Plastic and Reconstructive Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
3
Division of Plastic and Reconstructive Surgery, Shimane University Hospital, Shimane 693-0021, Japan
4
Department of Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki 856-8562, Japan
5
Department of Plastic and Reconstructive Surgery, Fukuoka Tokushukai Hospital, Fukuoka 816-0864, Japan
6
Department of Plastic and Reconstructive Surgery, Kitakyushu General Hospital, Kitakyushu 802-8517, Japan
7
Department of Plastic and Reconstructive Surgery, Ehime Prefectural Central Hospital, Ehime 790-0024, Japan
8
Department of Plastic and Reconstructive Surgery, Sasebo City General Hospital, Sasebo 857-0056, Japan
9
Department of Plastic and Reconstructive Surgery, Yamaguchi Prefectural Grand Medical Center, Osaki 747-8511, Japan
10
Department of Plastic and Reconstructive Surgery, Matsue Red Cross Hospital, Matsue 690-8506, Japan
*
Author to whom correspondence should be addressed.
Received: 8 November 2017 / Revised: 21 December 2017 / Accepted: 22 December 2017 / Published: 25 December 2017
(This article belongs to the Special Issue Recent Advances in Scar Biology)
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Abstract

Cultured epithelial autografts (CEA) with highly expanded mesh skin grafts were used for extensive adult burns covering more than 30% of the total body surface area. A prospective study on eight patients assessed subjective and objective findings up to a 12-month follow-up. The results of wound healing for over 1:6 mesh plus CEA, gap 1:6 mesh plus CEA, and 1:3 mesh were compared at 3, 6, and 12 months using extensibility, viscoelasticity, color, and transepidermal water loss by a generalized estimating equation (GEE) or generalized linear mixed model (GLMM). No significant differences were observed among the paired treatments at any time point. At 6 and 12 months, over 1:6 mesh plus CEA achieved significantly better expert evaluation scores by the Vancouver and Manchester Scar Scales (p < 0.01). Extended skin grafting plus CEA minimizes donor resources and the quality of scars is equal or similar to that with conventional low extended mesh slit-thickness skin grafting such as 1:3 mesh. A longitudinal analysis of scars may further clarify the molecular changes of scar formation and pathogenesis. View Full-Text
Keywords: split-thickness skin grafting; cultured epithelial autografts (CEA); assessment of scar quality; generalized estimating equation (GEE); generalized linear mixed model (GLMM) split-thickness skin grafting; cultured epithelial autografts (CEA); assessment of scar quality; generalized estimating equation (GEE); generalized linear mixed model (GLMM)
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Akita, S.; Hayashida, K.; Yoshimoto, H.; Fujioka, M.; Senju, C.; Morooka, S.; Nishimura, G.; Mukae, N.; Kobayashi, K.; Anraku, K.; Murakami, R.; Hirano, A.; Oishi, M.; Ikenoya, S.; Amano, N.; Nakagawa, H.; Nagasaki University plastic surgeons group. Novel Application of Cultured Epithelial Autografts (CEA) with Expanded Mesh Skin Grafting Over an Artificial Dermis or Dermal Wound Bed Preparation. Int. J. Mol. Sci. 2018, 19, 57.

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