Background: The gold standard in burn wound treatment is autologous split thickness skin grafting. Patients with major burns often undergo repeat rounds of skin grafting with lengthy hospital stays, multiple surgeries, high treatment costs and long recovery times. Full thickness skin grown in the laboratory, using a patient’s own cells, could reduce the time required to provide patients with permanent, complete wound coverage.
Results: The first step in growing skin grafts in the laboratory is isolating skin cells from a sample of unburnt patient skin for in vitro expansion of the cells. We have developed an isolation method that results in a mixture of skin cells which can be used to grow keratinocytes that form the epidermis, fibroblasts that form the dermis and melanocytes that provide pigmentation in skin.
A critical aspect of growing skin grafts in the laboratory for treating burn wounds is speed. Traditional keratinocyte growth media often require components such as choleratoxin and xenogeneic feeder cells to maximise growth rates. These components increase the regulatory burden for clinical application. We have developed a novel minimal keratinocyte growth medium that maximises keratinocyte growth rates but does not require choleratoxin or xenogeneic feeder cells.
Once the skin cells have been expanded in vitro they are then used to grow skin grafts that will be put onto the patient. We have developed a device that enables the production of 400 cm2 full thickness skin grafts with minimal manipulation.
Conclusions: We have developed methods that will maximise skin cell growth, reduce the regulatory burden of clinical application and simplify the production of large skin grafts for burn wound treatment.