CURRENT CONCEPTS IN THE DEVELOPMENT OF CULTURED SKIN REPLACEMENTS

Current tissue-culture techniques permit the rapid expansion of kerati nocyte populations, such that an area of cultured epithelium equivalen t to that of the surface of an adult can be obtained from an initial s mall skin biopsy. Unfortunately, technical obstacles have delayed the widespread clinical use of multilayered sheets of epithelium. These fa ctors include difficulties in preparing and transferring fragile cultu red epithelial sheets, as well as frequent unsatisfactory ''take'' of cultured grafts on the wound bed. As greater understanding of the comp lex interactions of cells and matrix evolves, so have new techniques i n the field of cultured keratinocytes for grafting. We have utilized a n animal model that allows us to examine some of these new methods and the factors which influence graft take. It has become clear that adhe sion properties of keratinocytes, early delivery of proliferative kera tinocytes to the wound, the development of dermal replacements, and im proved delivery systems for keratinocytes are important factors which must be considered for the optimal provision of skin replacements. (C) 1996 Academic Press, Inc.