The Usefulnesssof Cultured Allogenic Keratinocyte for Burn Treatment

화상치료에 있어서 동종유래표피세포의 유용성

  • Yoon, Sean Hyuck (Department of Plastic and Reconstructive Surgery, Collage of Medicine, Daegu Catholic University) ;
  • Shim, Jeong Su (Department of Plastic and Reconstructive Surgery, Collage of Medicine, Daegu Catholic University) ;
  • Jung, Jae Min (Department of Plastic and Reconstructive Surgery, Collage of Medicine, Daegu Catholic University) ;
  • Park, Dae Hwan (Department of Plastic and Reconstructive Surgery, Collage of Medicine, Daegu Catholic University) ;
  • Song, Chul Hong (Ivy Plastic Surgery Clinic)
  • 윤신혁 (대구가톨릭대학교 의과대학 성형외과학교실) ;
  • 심정수 (대구가톨릭대학교 의과대학 성형외과학교실) ;
  • 정재민 (대구가톨릭대학교 의과대학 성형외과학교실) ;
  • 박대환 (대구가톨릭대학교 의과대학 성형외과학교실) ;
  • 송철홍 (아이비 성형외과)
  • Received : 2008.03.31
  • Accepted : 2008.05.22
  • Published : 2008.07.10

Abstract

Purpose: When choosing dressing method to treat skin defect by second degree or higher burn, we have to consider method of rapid epithelization and minimization of pain during the treatment. In this study, we used biologic dressing with cultured allogenic keratinocytes for skin defect due to burn. We followed up the degree of epithelization, the degree of pain, and patient satisfaction. Methods: From June 2003 to June 2006, among the patients with skin defect due to burn, 31 cases with second degree burn(moderate to severe) were selected and biological dressing with cultured allogenic keratinocytes were done. 21 cases did not use cultured allogenic keratinocytes. Most of the patients had second degree burn. We applied cultured allogenic keratinocyte by Kaloderm. For wounds that were not deep enough to effect the dermis, escharectomy was done before applying Kaloderm. After the operation, moist wound site was maintained by dressing with saline gauze for 5 - 7 days. We compared the condition of the wound site before and after applying Keloderm by grading epithelization by standardized percentage scoring scale(1 - 5), and degree of pain and patient satisfaction by visual analogue scale(0 - 10). Results: When cultured allogenic keratinocytes were applied for the same period of time, the mean score of epithelization were $3.29{\pm}0.529$(mean ${\pm}$ S.D.). Without the application, the mean score of epithelization were $2.86{\pm}0.655$(mean ${\pm}$ S.D.). The degree of pain was $7.71{\pm}1.419$(mean ${\pm}$ S.D.) and $2.35{\pm}0.950$(mean ${\pm}$ S.D.) before and after the application, respectively. The patients' satisfaction score was $6.45{\pm}0.850$(mean ${\pm}$ S.D.) and $8.45{\pm}0.961$(mean ${\pm}$ S.D.) before and after the application, respectively. Conclusion: Applying biological dressing with cultured allogenic keratinocyte to skin defect due to second degree burn showed satisfactory results in the degree of the epithelization, degree of pain and patients' satisfaction.

Keywords

References

  1. Rheinwald JG, Green H: Serial cultivation of stains of human epidermal keratinocytes: the formation of keratinizing colonies from single cells. Cell 6: 331, 1975 https://doi.org/10.1016/S0092-8674(75)80001-8
  2. Hauser C, Saurat JH, Schmitt A, Jaunin F, Dayer JM: Interleukin 1 is present in normal human epidermis. J Immunol 136: 3317, 1986
  3. Danna M, Luger TA: Human keratinocytes and epidermoid carcinoma cell lines produce a cytokine with interleukin 3-like activity. J Invest Dermatol 88: 353, 1987 https://doi.org/10.1111/1523-1747.ep12469013
  4. Coffey RJ Jr, Derynck R, Wilcox JN, Bringman TS, Goustin AS, Moses HL, Pittelkow MR: Production and auto-induction of transforming growth factor-$\alpha$ in human keratinocyte. Nature 328: 817, 1987 https://doi.org/10.1038/328817a0
  5. Krueger JG, Krane JF, Carter DM, Gottlieb AB: Role of growth factors, cytokines and their receptors in the pathogenesis of psoriasis. J Invest Dermatol 94: 135, 1990 https://doi.org/10.1111/1523-1747.ep12876121
  6. Lavker RM, Sun TT: Heterogeneity in epidermal basal keratinocytes: morphological and functional correlations. Science 215: 1239, 1982 https://doi.org/10.1126/science.7058342
  7. Lavker RM, Sun TT: Epidermal stem cells. J Invest Dermatol 81: 121s, 1983 https://doi.org/10.1111/1523-1747.ep12540880
  8. Eisinger M, Sadan S, Silver IA, Flick RB: Growth regulation of skin cells by epidermal cell derived factor: implications for wound healing. Proc Natl Acad Sci USA 85: 1937, 1988
  9. O'Connor NE, Mulliken JB, Banks-Schlegel S, Kehinde O, Green H: Grafting of burns with cultured epithelium prepared from autologous epidermal cells. Lancet 1: 75, 1981 https://doi.org/10.1016/S0140-6736(02)95560-1
  10. Fratianne R, Papay F, Housini I, Lang C, Schafer IA: Keratinocyte Allografts accelerate healing of split- thickness donor sites: applications for improved treatment of burns. J Burn Care Rehabil 14: 148, 1993 https://doi.org/10.1097/00004630-199303000-00004
  11. Choi JH, Ko JH, Seo DK, Lee JW, Jeon SW, Oh SJ, Jang YC: Treatment of partial thickness burn wounds with cultured epidermal homografts. J Korean Soc Plast Reconstr Surg 33: 587, 2006
  12. Braye F, Pascal P, Bertin-Maghit M, Colpart JJ, Tissot E, Damour O: Advantages of using a bank of allogenic keratinocytes for the rapid coverage of extensive and deep second-degree burns. Med Biol Eng Comput 38: 248, 2000 https://doi.org/10.1007/BF02344784