Wundheilung am Schwein nach Transplantation einer Keratinozyten-Fibrin-Kleber-Suspension und azellulärer Dermis

Abstract

Successful epidermal regeneration by transplantation of cultured autologous keratinocytes as a single cell suspension in fibrin sealant has been shown clinically and experimentally in the nude mouse model. The advantages of using shortly cultivated keratinoctyes concerning both easy application and the wound healing potential of such a suspension have been discussed elsewhere.

The aim of this study was to combine the keratinocyte fibrin sealant suspension technique and a dermal matrix (AlloDerm™, LifeCell Inc., The Woodlands, TX) in a pig animal model. Full thickness skin defects (n = 6 per animal, 5x5 cm) in pigs (n = 10) were grafted with autologous cultured pig keratinocytes as fibrin sealant (Tisseel™, Baxter AG, Vienna) suspension, either with or without meshed acellularized dermis. Control wounds received either fibrin sealant or fibrin sealant and acellularized dermis without cells. Macroscopic wound healing including wound contraction measurement was studied for 4 weeks. Histological investigations included morphological (H&E, Elastica van Gieson), immunhistochemical (type VII collagen) and electronmicroscopical aspects.

The take of keratinocyte fibrin sealant suspensions with or without acellularized dermis was about 70%. Wound healing in both control groups was significantly delayed. Wound contraction was significantly reduced by the combination of dermis and keratinocytes. Histologically, the integration of acellular dermis could be shown. However, after two weeks signs of beginning dermal turnover could be noticed. Basement membrane reconstitution in both cell grafted groups was consistent.

The successful combination of a keratinocyte fibrin sealant suspension and acellular dermis in an attempt to regenerate full thickness skin defects in a pig animal model is shown for the first time with this study. The usefulness of subconfluently cultured keratinocytes — which can be harvested very early and are easy to handle — is enhanced by the possibility of co-transplantation with decellularized dermis.