A new technique to resurface wounds with composite biocompatible epidermalgraft and artificial skin

Background: The incorporation of cultured epidermal autograft on the neoder mis of artificial skin (Integra, Integra LifeSciences, Plainsboro, NJ) has been met with some difficulties, A new engraftment technique to resurface t he wounds with Integra and composite biocompatible epidermal graft (CBEG) h as been successfully applied on three patients for elective reconstructive procedures, Methods: A small skin biopsy was taken from the normal edge of the lesion f or keratinocytes and dermal fibroblast cultures 2 weeks before surgery. Whe n sufficient cells were grown, the patient was admitted for the excision of the lesions or scars, The wounds of the patients, ranging from 125 to 250 cm(2), mere covered with Integra, When the neodermis of the Integra was ful ly vascularized, the silicone membrane of the Integra was removed and repla ced with the CBEG, which consisted of autologous keratinocytes cultivated o n a hyaluronate-derived membrane (Laserskin; Fidia Advanced Biopolymers, Ab ano Terme, Italy)) using human dermal fibroblasts as a feeder layer. Results: Clinically, there was good initial "take" of the CBEGs in these th ree patients, ranging from 50% to 100%. Biopsy specimens of the grafted wou nds were taken 1 to 3 weeks after the application of the CBEGs. Epitheliali zation was noted in all patients, Conclusion: This engraftment technique has several advantages, The CBEG is much easier to handle than the conventional cultured epidermal autograft, I t eliminates the invasive second procedure for skin harvesting, with result ing pain and scarring, The application of the CBEG can be easily performed at the bedside.