Vollhautersatz durch Kombination einer autologen Keratinozyten-Fibrinkleber-Suspension und Fibroblasten in Kombination mit einer azellulären Dermis — experimentelle Langzeituntersuchung am Schweinemodell

Abstract

The use of cultured autologous keratinocytes as a single cell suspension in fibrin glue for epidermal regeneration has already been reported. In this study we intended to create a single-step method of transplanting autologous keratinocytes and a acellular dermal equivalent in combination with autologous fibroblasts. On the dorsum of 9 german standard pigs 54 full thickness wounds (5cm×5cm) were created. Acellular dermis was pre-incubated with autologous fibroblasts and transplanted to the wounds. An overlaying Keratinocyte-Fibrin-Glue-Suspension (KFGS) was applied. As controls served wounds only with a Keratinocyte-Fibrin-Glue-Suspension or a Fibroblast-Keratinocyte-Fibrin-Glue-Suspension. The epidermal regeneration was regular over the observation period of 4 weeks (n = 5) and 6 months (n = 4) and showed good mechanical stability while tested by a suction-blister test. Both dermal equivalents showed a reduced wound contraction especially when combined with fibroblasts. The dermal matrix first showed good integration but underwent a dermal turnover after 2 weeks. Histological evaluations showed a differentiation of the epithelium with an intact basement membrane. This longterm study suggests that these tissue engineered full thickness skin grafts were able to cope with everyday challenges.