A randomized single-blind controlled study of cultured epidermal allografts in the treatment of split-thickness skin graft donor sites

Abstract

Background and design: In uncontrolled studies, cultured keratinocytes derived from donor tissue (allografts) appear to accelerate healing in a variety of acute and chronic skin wounds ranging from burns to leg ulcers. A randomized clinical trial was undertaken to compare the healing time of split-thickness skin graft donor sites in elderly patients using cultured epidermal allografts vs nonadherent dressings. Fresh-cultured epidermal grafts were used in 10 split-thickness skin graft donor sites in nine patients ranging in age from 63 to 87 years. In each patient, half the donor site was allografted and the other half treated with nonadherent dressings. To provide information about allograft survival, biopsy specimens were taken from allografted areas in three patients 2 months after the grafting procedure, for multilocus DNA analysis.

Results: The mean time to complete healing was 8.4 days in allografted sites compared with 15.3 days in control sites. There was no evidence of survival of cultured allogeneic cells in allografted areas.

Conclusion: Cultured allografts can accelerate healing in split-thickness skin graft donor sites in elderly patients compared with nonadherent dressings. Cultured allografts do not survive permanently on the wound bed.