Necrobiotic process causing burn wound conversion may be prevented by allogeneic keratinocytes delivered by the recombined human/pig skin

The spontaneous necrobiotic process frequently causes conversion of DDB (de ep 2(nd) degree wounds) into full-thickness skin loss (3(rd) degree wounds) . We found that this process may be positively influenced by the activity o f living human allogeneic keratinocytes cultured on acellular pig dermis. T his RHPS, if applied 'upside-down' with the epidermal layer facing the woun d, provides an opportunity for keratinocytes to influence the healing. The aim of the present study was to find conditions, in terms of timing and wou nd-bed preparation, for optimum healing activity of RHPS. The wound beds we re prepared either with tangential excision, surface dermabrasion or deep d ermabrasion. Out of 17 wounds grafted with RHPS after tangential excision, 15 (88%) healed in 4-10 days; early excised wounds (up to day 5) healed wit hin less than 10 days after the injury. Out of 8 wounds grafted after surfa ce dermabrasion, only 2 (25%) healed. Out of 6 wounds grafted with RHPS aft er deep dermabrasion, 4 (67%) healed. The optimum healing effect of RHPS an d prevention of conversion was achieved in early tangentially excised wound s.