In vitro reconstructed dermis implanted in human wounds: degradation studies of the HA-based supporting scaffold

The objective of the present study was to demonstrate the safety and effica cy of a dermal replacement for cutaneous wounds of diverse origin. Autologo us fibroblasts were cultured in fleece scaffolds made from benzyl esters of hyaluronic acid and applied onto cutaneous lesions. The cases presented ar e (1) skin removal for multiple epithelioma and (2) chronic deep decubitus ulcer. Dermal-like tissue applied by the surgeon elicited no adverse reacti ons, and was fully integrated and well-vascularized by 1-3 weeks. In Case I , the material was fully integrated after 1 week, and after 3 weeks an epid ermal autograft was overlaid which showed good take with excellent integrat ion observed after 4 weeks. At 12 months, skin demonstrated visual normo-el astic properties and no signs of excessive scarring. In Case 2, 2-3 weeks a fter the dermal implant was applied, the wound was invaded with granulation tissue and healing occurred by secondary intention. The ulcer was healed b y 8 weeks, with the biomaterial completely resorbed and a complete re-epith elialization over the dermal-like tissue. These results suggest that autolo gous fibroblast culture in hyaluronan-derived scaffolds may be successfully grafted in diverse cutaneous pathologies and constitute a suitable bed for further epidermal implantation. (C) 2000 Elsevier Science Ltd. All rights reserved.