Use Of Autologous Skin Columns In Porcine Deep-partial Thickness Burn Wound Healing
Anders Carlsson, Tyler Everett, Kai Leung, Rodney Chan.
US Army Institute of Surgical Research, San Antonio, TX, USA.
Burn wounds and injuries present a series of issues for both military and civilian casualties. This study compares the use of full-thickness skin columns (FTSC) to current therapy of split-thickness skin grafts (STSG) in deep partial thickness burn (DPTB) porcine wound models. STSG results in hypertrophic scarring, wound contracture, absent adnexal structures, and skin re-harvest from donor sites. We have demonstrated that FTSCs of 1.5 mm in diameter can be easily harvested with minimal donor site morbidity and can cover areas up to 10x larger than the harvest site. We hypothesized FTSCs will exhibit improved healing and scar outcomes in donor and wound sites of a porcine DPTB wound model. Five animals received ten thermal DPTBs of 58 cm2 each that were induced with a thermocoupled burn device (100°C) on the dorsal skin of anesthetized pigs. The wounds were debrided seven days later and FTSCs were harvested at the neck region. Wound area tracing, perfusion, histologic data, and POSAS was collected over the 90 day experimental time frame. This work was reviewed and approved by the Institutional Animal Care and Use Committee (IACUC) at the USAISR. Improvement was demonstrated in re-epithelialization and perfusion of the wound sites. FTSCs can be used successfully to improve healing. The FTSC donor sites heal quicker than traditional STSG donor sites and without the complications of traditional dermatome harvesting. STSG are limited in re-harvest potential as donor site skin availability lessens. This porcine study highlights the value in transplanting skin microcolumns as an alternative treatment with reduced sequela.
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