A comparative study of spray keratinocytes and autologous meshed split-thickness skin graft in the treatment of acute burn injuries

Rajiv Sood, David Edward Roggy, Madeline Jane Zieger, Muhammad Nazim, Brett Colby Hartman, Jeff Thomas Gibbs

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background. ReCell (Avita Medical, Northridge, CA) is an autologous cell harvesting (ACH) device that enables a thin splitthickness skin biopsy to be processed to produce a cell population that includes a mixed population of keratinocytes, melanocytes, Langerhans cells, and papillary dermal fibroblasts for immediate delivery via a spray applicator onto a prepared skin surface. Materials and Methods. In this Institutional Review Board-approved US Food and Drug Administration phase 2 study, the authors prospectively evaluated the treatment of partial-thickness burns in patients with two 320 cm2 areas, 1 area treated with the ACH device and the other with a meshed split-thickness skin graft (MSTSG) as a control. The authors compared the treatment areas for graft take, pigmentation, and color match to surrounding healthy tissue, scarring, and pain. Results. In this preliminary study, 10 patients were treated with this protocol. Eight patients had 100% take to both treatment areas and 2 patients had significant non-take and graft loss attributable to underexcised wound beds and difficulty with the spray applicator. Pigmentation and color match ratings were identical at week 52 and the Modified Vancouver Scar Scale scores were comparable. One subject rated the autologous cell harvesting site as having a better appearance, while the remaining subjects rated their ACH and MSTSG sites' appearances as being comparable. In early follow-up visits, pain ratings were slightly elevated in the ACH group due to graft healing; however, in visits following week 2, pain ratings at the ACH and MSTSG sites were rated similarly by all patients. Conclusion. This preliminary report describes an early experience with the ACH device and the treatment of partial-thickness burn injuries. In this 10-patient series, patients benefitted from having a decreased donor site size and comparable outcomes with MSTSG treatment. While this preliminary underpowered study has provided positive results, there is a learning curve with choosing the proper wound for treatment with the ACH device, as well as with using the device.

Original languageEnglish
Pages (from-to)31-40
Number of pages10
JournalWounds
Volume27
Issue number2
StatePublished - Feb 1 2015

Fingerprint

Keratinocytes
Transplants
Skin
Wounds and Injuries
Equipment and Supplies
Therapeutics
Pigmentation
Cicatrix
Color
Nociceptive Pain
Pain
Learning Curve
Langerhans Cells
Research Ethics Committees
Melanocytes
United States Food and Drug Administration
Burns
Population
Fibroblasts
Tissue Donors

Keywords

  • burn
  • skin graft
  • spray keratinocytes

ASJC Scopus subject areas

  • Surgery
  • Medical–Surgical

Cite this

Sood, R., Roggy, D. E., Zieger, M. J., Nazim, M., Hartman, B. C., & Gibbs, J. T. (2015). A comparative study of spray keratinocytes and autologous meshed split-thickness skin graft in the treatment of acute burn injuries. Wounds, 27(2), 31-40.

A comparative study of spray keratinocytes and autologous meshed split-thickness skin graft in the treatment of acute burn injuries. / Sood, Rajiv; Roggy, David Edward; Zieger, Madeline Jane; Nazim, Muhammad; Hartman, Brett Colby; Gibbs, Jeff Thomas.

In: Wounds, Vol. 27, No. 2, 01.02.2015, p. 31-40.

Research output: Contribution to journalArticle

Sood, R, Roggy, DE, Zieger, MJ, Nazim, M, Hartman, BC & Gibbs, JT 2015, 'A comparative study of spray keratinocytes and autologous meshed split-thickness skin graft in the treatment of acute burn injuries', Wounds, vol. 27, no. 2, pp. 31-40.
Sood, Rajiv ; Roggy, David Edward ; Zieger, Madeline Jane ; Nazim, Muhammad ; Hartman, Brett Colby ; Gibbs, Jeff Thomas. / A comparative study of spray keratinocytes and autologous meshed split-thickness skin graft in the treatment of acute burn injuries. In: Wounds. 2015 ; Vol. 27, No. 2. pp. 31-40.
@article{d00aa2e8177140b78735eb736d7b05e3,
title = "A comparative study of spray keratinocytes and autologous meshed split-thickness skin graft in the treatment of acute burn injuries",
abstract = "Background. ReCell (Avita Medical, Northridge, CA) is an autologous cell harvesting (ACH) device that enables a thin splitthickness skin biopsy to be processed to produce a cell population that includes a mixed population of keratinocytes, melanocytes, Langerhans cells, and papillary dermal fibroblasts for immediate delivery via a spray applicator onto a prepared skin surface. Materials and Methods. In this Institutional Review Board-approved US Food and Drug Administration phase 2 study, the authors prospectively evaluated the treatment of partial-thickness burns in patients with two 320 cm2 areas, 1 area treated with the ACH device and the other with a meshed split-thickness skin graft (MSTSG) as a control. The authors compared the treatment areas for graft take, pigmentation, and color match to surrounding healthy tissue, scarring, and pain. Results. In this preliminary study, 10 patients were treated with this protocol. Eight patients had 100{\%} take to both treatment areas and 2 patients had significant non-take and graft loss attributable to underexcised wound beds and difficulty with the spray applicator. Pigmentation and color match ratings were identical at week 52 and the Modified Vancouver Scar Scale scores were comparable. One subject rated the autologous cell harvesting site as having a better appearance, while the remaining subjects rated their ACH and MSTSG sites' appearances as being comparable. In early follow-up visits, pain ratings were slightly elevated in the ACH group due to graft healing; however, in visits following week 2, pain ratings at the ACH and MSTSG sites were rated similarly by all patients. Conclusion. This preliminary report describes an early experience with the ACH device and the treatment of partial-thickness burn injuries. In this 10-patient series, patients benefitted from having a decreased donor site size and comparable outcomes with MSTSG treatment. While this preliminary underpowered study has provided positive results, there is a learning curve with choosing the proper wound for treatment with the ACH device, as well as with using the device.",
keywords = "burn, skin graft, spray keratinocytes",
author = "Rajiv Sood and Roggy, {David Edward} and Zieger, {Madeline Jane} and Muhammad Nazim and Hartman, {Brett Colby} and Gibbs, {Jeff Thomas}",
year = "2015",
month = "2",
day = "1",
language = "English",
volume = "27",
pages = "31--40",
journal = "Wounds",
issn = "1044-7946",
publisher = "HMP Communications",
number = "2",

}

TY - JOUR

T1 - A comparative study of spray keratinocytes and autologous meshed split-thickness skin graft in the treatment of acute burn injuries

AU - Sood, Rajiv

AU - Roggy, David Edward

AU - Zieger, Madeline Jane

AU - Nazim, Muhammad

AU - Hartman, Brett Colby

AU - Gibbs, Jeff Thomas

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Background. ReCell (Avita Medical, Northridge, CA) is an autologous cell harvesting (ACH) device that enables a thin splitthickness skin biopsy to be processed to produce a cell population that includes a mixed population of keratinocytes, melanocytes, Langerhans cells, and papillary dermal fibroblasts for immediate delivery via a spray applicator onto a prepared skin surface. Materials and Methods. In this Institutional Review Board-approved US Food and Drug Administration phase 2 study, the authors prospectively evaluated the treatment of partial-thickness burns in patients with two 320 cm2 areas, 1 area treated with the ACH device and the other with a meshed split-thickness skin graft (MSTSG) as a control. The authors compared the treatment areas for graft take, pigmentation, and color match to surrounding healthy tissue, scarring, and pain. Results. In this preliminary study, 10 patients were treated with this protocol. Eight patients had 100% take to both treatment areas and 2 patients had significant non-take and graft loss attributable to underexcised wound beds and difficulty with the spray applicator. Pigmentation and color match ratings were identical at week 52 and the Modified Vancouver Scar Scale scores were comparable. One subject rated the autologous cell harvesting site as having a better appearance, while the remaining subjects rated their ACH and MSTSG sites' appearances as being comparable. In early follow-up visits, pain ratings were slightly elevated in the ACH group due to graft healing; however, in visits following week 2, pain ratings at the ACH and MSTSG sites were rated similarly by all patients. Conclusion. This preliminary report describes an early experience with the ACH device and the treatment of partial-thickness burn injuries. In this 10-patient series, patients benefitted from having a decreased donor site size and comparable outcomes with MSTSG treatment. While this preliminary underpowered study has provided positive results, there is a learning curve with choosing the proper wound for treatment with the ACH device, as well as with using the device.

AB - Background. ReCell (Avita Medical, Northridge, CA) is an autologous cell harvesting (ACH) device that enables a thin splitthickness skin biopsy to be processed to produce a cell population that includes a mixed population of keratinocytes, melanocytes, Langerhans cells, and papillary dermal fibroblasts for immediate delivery via a spray applicator onto a prepared skin surface. Materials and Methods. In this Institutional Review Board-approved US Food and Drug Administration phase 2 study, the authors prospectively evaluated the treatment of partial-thickness burns in patients with two 320 cm2 areas, 1 area treated with the ACH device and the other with a meshed split-thickness skin graft (MSTSG) as a control. The authors compared the treatment areas for graft take, pigmentation, and color match to surrounding healthy tissue, scarring, and pain. Results. In this preliminary study, 10 patients were treated with this protocol. Eight patients had 100% take to both treatment areas and 2 patients had significant non-take and graft loss attributable to underexcised wound beds and difficulty with the spray applicator. Pigmentation and color match ratings were identical at week 52 and the Modified Vancouver Scar Scale scores were comparable. One subject rated the autologous cell harvesting site as having a better appearance, while the remaining subjects rated their ACH and MSTSG sites' appearances as being comparable. In early follow-up visits, pain ratings were slightly elevated in the ACH group due to graft healing; however, in visits following week 2, pain ratings at the ACH and MSTSG sites were rated similarly by all patients. Conclusion. This preliminary report describes an early experience with the ACH device and the treatment of partial-thickness burn injuries. In this 10-patient series, patients benefitted from having a decreased donor site size and comparable outcomes with MSTSG treatment. While this preliminary underpowered study has provided positive results, there is a learning curve with choosing the proper wound for treatment with the ACH device, as well as with using the device.

KW - burn

KW - skin graft

KW - spray keratinocytes

UR - http://www.scopus.com/inward/record.url?scp=84922608210&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922608210&partnerID=8YFLogxK

M3 - Article

C2 - 25785905

AN - SCOPUS:84922608210

VL - 27

SP - 31

EP - 40

JO - Wounds

JF - Wounds

SN - 1044-7946

IS - 2

ER -