Treatment of full skin thickness burn injury using cultured epithelial grafts

Abstract

This report presents the experience gained from 26 patients treated with autogenic cultured epithelial grafts (auto-CEG). All auto-CEG were applied to wounds clinically defined as full skin thickness injury. In total 89 separate sites were grafted. The overall estimate of 'take' ranged from 0 to 98 per cent with a mean value of 15 per cent. The highest level of 'take' (43 per cent) was observed when auto-CEG were applied to wounds which had been previously covered with allogenic split-thickness skin grafts. An increased incidence of wound colonization with pathogenic species of bacteria corresponded with a decreased graft 'take'. Ps. aeruginosa and Staph. aureus were found to be present on 32.6 per cent and 60.5 per cent of wound swabs respectively, where 10 per cent or less 'take' of auto-CEG was seen, indicating that bacterial infection is in part responsible for graft failure. However, in 20.9 per cent of such instances, no growth of bacteria was detected, perhaps suggesting that certain wound beds may not present the correct physical environment necessary to support proliferating epithelial cells isolated from their underlying dermal component.