RECONSTITUTED SKIN

THE CURRENT ACCEPTED TREATMENT FOR REPLACING FULL-THICKNESS SKIN LOST TO INJURY OR ULCERATION IS TO GRAFT HEALTHY, SPLIT-THICKNESS SKIN (SSG) FROM AN UNINJURED AREA OF THE BODY TO THE WOUND SITE. TREATMENT IS TYPICALLY COMPLICATED BY PAIN AND TRAUMA TO THE DONOR SITE AND SCARRING AND CONTRACTURE AT THE WOUND SITE. AN ALTERNATIVE TO THE USE OF SSG HAS BEEN TO EXPAND A SMALL BIOPSY OF THE PATIENT'S EPIDERMIS UP TO 1000-FOLD IN CELL CULTURE. CLINICAL USE OF THESE CULTURED KERATINOCYTES ON A FULL-THICKNESS SKIN DEFECT HAS RESULTED IN FRAGILE SKIN, PRONE TO ULCERATION AND EXTREME SCARRING. RESEARCHERS HAVE DEVELOPED A BIOENGINEERED ACELLULAR DERMAL REPLACEMENT WHICH IS CURRENTLY UNDER CLINICAL INVESTIGATION AS A FOUNDATION FOR A THIN SSG IN A FULL-THICKNESS INJURY. THE AIM IS TO EXAMINE THE POSSIBILITIES OF CULTURING KERATINOCYTES ONTO THIS PROCESSED DERMAL MATRIX TO DEVELOP A COMPLETE SKIN RECONSTITUTION SYSTEM. INVESTIGATIONS FOCUS FIRST ON OPTIMIZING KERATINOCYTE GROWTH UNDER STANDARD CONDITIONS AND THEN IN CO-CULTURE WITH DERMIS. CO-CULTURE CONDITIONS ARE BEING ASSESSED FOR THEIR IMPACT ON WOUND HEALING.