Autologous Homologous Skin Cell Cluster Graft Regenerates Functionally Normal Skin Within a Chronic Nonhealing Leg Wound Refractory to Skin GraftingMark Granick, MD; and Stephen Milner, MD, DDS, DSc
BACKGROUND: The prevalence of chronic, nonhealing wounds is 1% to 2% of the general population, with Medicare expenditures estimated to range as high as $96.8 billion. Advances in chronic wound treatments have the potential to expedite healing times and reduce the overall economic burden on the health care system. The autologous homologous skin cell cluster graft (AHSG) is a new autologous-derived product to regenerate full-thickness, functional skin with all of its layers and appendages.
OBJECTIVE: The purpose of this study was to compare the results obtained with AHSG versus split-thickness skin grafting (STSG) in the treatment of a chronic, nonhealing leg wound.
MATERIALS AND METHODS: The study is an intraindividual analysis of outcomes achieved utilizing AHSG versus STSG in the treatment of a chronic leg wound in comparison to native skin. The study sample is composed of a single patient that suffered bilateral traumatic leg wounds initially treated with STSGs. The right leg wound failed 2 treatments with STSG and ultimately was treated with AHSG 2 years after injury; the left leg wound healed uneventfully with the original STSG. Intrawound and interwound outcomes were assessed, including graft take, time to wound coverage, donor site morbidity, hair regeneration, pigment regeneration, sensation, sweat and sebaceous gland production, and pliability.
RESULTS: Length of follow-up was 30 months from the date of initial injury and 6 months following treatment with AHSG. Within the chronic, nonhealing right leg wound, the AHSG demonstrated complete graft take and full wound closure within 3 months in comparison with complete graft loss of 2 prior STSGs and failure to obtain wound closure over the course of 2 years with multiple modalities. In comparison with native uninjured skin, AHSG demonstrated equivalent 2-point discrimination, pliability, and sweat and oil gland production, all of which were significantly decreased in the healed STSG on the left lower extremity. The AHSG regenerated hair follicles and pigment that were qualitatively and quantitatively equivalent to native uninjured skin, whereas the split-thickness skin graft was incapable of regenerating hair follicles and pigmentation was significantly different from native skin.
CONCLUSIONS: The AHSG is capable of regenerating functionally normal skin within chronic, nonhealing wounds refractory to all other treatment options, including STSG. The skin regenerated by AHSG is qualitatively and quantitatively equivalent to native skin across multiple functions and characteristics, including sensation, hair follicle morphology and composition, pigment regeneration, and gland production. The AHSG has the potential to reduce the economic burden of chronic wounds if similar results can be achieved consistently.
Granick M, Milner S. Autologous homologous skin cell cluster graft regenerates functionally normal skin within a chronic nonhealing leg wound refractory to skin grafting. Poster presented at: Symposium on Advanced Wound Care Fall; November 2-4, 2018; Las Vegas, NV.
Product: SkinTE, PolarityTE, Inc (Salt Lake City, UT)
This abstract was not subject to the WOUNDS peer-review process.