The use of autologous and bioengineered epidermis to control fibrosis and improve cosmesis

Pure epidermal sheet or cultured keratinocyte sheet grafts For the treatmen t of dermal wounds have become a popular technique. We prepare pure epiderm al sheets from blister roof or by dispase treatment of excised skin. Autolo gous keratinocyte culture sheets are prepared by routine two-step culture t echniques and, if necessary, cryopreserved for repeated use. Due to Fibrosi s and contraction of the healed wound, it is generally believed that the th inner the transplanted skin tissue, the less satisfactory the cosmetic resu lt; however, our experiences indicate thin tissues such as epidermal sheets or cultured keratinocyte sheets can be used for relatively shallow wounds with satisfactory cosmetic results. Unique dermatologic applications of thi s technique are presented to treat recurrent chronic ulcers and hand deform ities of epidermolysis bullosa patients, severe acne scars, and tattoo remo val as examples to control fibrosis.