By Karla Gale
NEW YORK (Reuters Health) – Genetically engineered tissue dressings derived from fetal skin cells have been used successfully to treat second- and third-degree burns without scarring in pediatric patients, researchers in Switzerland report.
The use of fetal tissue in wound repair could avoid difficulties of tissue engineering, such as immune rejection, small growth capacity and incompatibility, Dr. Lee Ann Laurent-Applegate and colleagues note in their report, published online August 18 by The Lancet.
“The main advantage was that we could avoid a (skin graft) procedure in all cases,” study co-author Dr. Patrick Hohlfeld told Reuters Health.
The research team, based at University Hospital of Lausanne, obtained a 4-cm skin donation from a 14-week aborted male fetus. Cells were expanded in culture and used to seed collagen sheets, and then grown for two more days before the sheets were applied to the burn wounds.
The fetal cells were used to treat eight children considered to be candidates for traditional skin grafting, approximately 10 days after their injury. As the cells biodegraded, they were replaced every three to four days.
“These cells stimulate spontaneous healing of the wound through secretion of multiple growth factors,” Hohlfeld said. The average time to healing was 15.3 days after the first cell application.
The cosmetic and functional results “were excellent in all eight children,” who had little degradation of the new skin with no retraction or breakdown of the healed surfaces, the research team reports. The one patient who had dark skin had recovery of skin pigmentation.
The researchers estimate that the one fetal skin donation could yield “several million” skin constructs. “We only need one very small biopsy once, giving us the potential to treat thousands of people,” Hohlfeld pointed out. He considers it possible to obtain effective skin cells from miscarriages of second trimester fetuses.
And although fetal skin cells have not yet been used to treat adults, he expects that similar tissue dressing constructs will be successful in treating other types of wounds, such as bedsores and venous leg ulcers.
SOURCE: The Lancet, August 18, 2005.
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