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A Pilot Study of Negative Pressure Therapy with Autologous Skin Cell Suspensions in a Porcine Model.

MedStar author(s):

Carney, Bonnie C

Keyloun, John

Citation: Journal of Surgical Research. 267:182-196, 2021 11.PMID: 34153561Institution: MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment: Burn Research Fellowship | Firefighters' Burn and Surgical Research Laboratory | Surgery/Burn ServicesForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Burns | *Negative-Pressure Wound Therapy | Animals | Burns/pa [Pathology] | Pilot Projects | Skin Transplantation | Skin/pa [Pathology] | Suspensions | SwineYear: 2021 ISSN:

0022-4804

Name of journal: The Journal of surgical researchAbstract: BACKGROUND: Negative pressure wound therapy (NPWT) is an option for securing meshed split thickness skin grafts (mSTSGs) after burn excision to optimize skin graft adherence. Recently, the use of autologous skin cell suspension (ASCS) has been approved for use in the treatment of burn injuries in conjunction with mSTSGs.To date, limited data exists regarding the impact of NPWT on healing outcomes when the cellular suspension is utilized. It was hypothesized that NPWT would not negatively impact wound healing of ASCS+mSTSG.CONCLUSIONS: These data suggest the positive attributes of the cellular suspension delivered are retained following the application of negative pressure. Re-epithelialization, revascularization, and repigmentation are not adversely impacted. The use of NPWT may be considered as an option when using ASCS with mSTSGs for the treatment of full-thickness burns. Copyright (c) 2021 The Authors. Published by Elsevier Inc. All rights reserved.MATERIALS AND METHODS: A burn, excision, mSTSG, ASCS +/- NPWT model was used. Two Duroc pigs were utilized in this experiment, each with 2 sets of paired burns. Four wounds received mSTSG+ASCS+NPWT through post-operative day 3, and 4 wounds received mSTSG+ACSC+ traditional ASCS dressings. Cellular viability was characterized prior to spraying. Percent re-epithelialization, graft-adherence, pigmentation, elasticity, and blood perfusion and blood vessel density were assessed at multiple time points through 2 weeks.RESULTS: All wounds healed within 14 days with minimal scar pathology and no significant differences in percent re-epithelialization between NPWT, and non-NPWT wounds were observed. Additionally, no differences were detected for pigmentation, perfusion, or blood vessel density. NPWT treated wounds had less graft loss and improved elasticity, with elasticity being statistically different.All authors: Carney BC, Keyloun JW, Kirkpatrick LD, Moffatt LT, Nisar S, Oliver MA, Prindeze NJ, Shupp JW, Travis TEOriginally published: Journal of Surgical Research. 267:182-196, 2021 Nov.Fiscal year: FY2022 Digital Object Identifier:

https://dx.doi.org/10.1016/j.jss.2021.05.010

Date added to catalog: 2021-07-19

Holdings ( 1 )
Title notes ( 5 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	34153561	Available		34153561

BACKGROUND: Negative pressure wound therapy (NPWT) is an option for securing meshed split thickness skin grafts (mSTSGs) after burn excision to optimize skin graft adherence. Recently, the use of autologous skin cell suspension (ASCS) has been approved for use in the treatment of burn injuries in conjunction with mSTSGs.To date, limited data exists regarding the impact of NPWT on healing outcomes when the cellular suspension is utilized. It was hypothesized that NPWT would not negatively impact wound healing of ASCS+mSTSG.

CONCLUSIONS: These data suggest the positive attributes of the cellular suspension delivered are retained following the application of negative pressure. Re-epithelialization, revascularization, and repigmentation are not adversely impacted. The use of NPWT may be considered as an option when using ASCS with mSTSGs for the treatment of full-thickness burns. Copyright (c) 2021 The Authors. Published by Elsevier Inc. All rights reserved.

MATERIALS AND METHODS: A burn, excision, mSTSG, ASCS +/- NPWT model was used. Two Duroc pigs were utilized in this experiment, each with 2 sets of paired burns. Four wounds received mSTSG+ASCS+NPWT through post-operative day 3, and 4 wounds received mSTSG+ACSC+ traditional ASCS dressings. Cellular viability was characterized prior to spraying. Percent re-epithelialization, graft-adherence, pigmentation, elasticity, and blood perfusion and blood vessel density were assessed at multiple time points through 2 weeks.

RESULTS: All wounds healed within 14 days with minimal scar pathology and no significant differences in percent re-epithelialization between NPWT, and non-NPWT wounds were observed. Additionally, no differences were detected for pigmentation, perfusion, or blood vessel density. NPWT treated wounds had less graft loss and improved elasticity, with elasticity being statistically different.

English