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Experience of Using Cultured Epithelial Autografts for the Extensive Burn Wounds in Eight Patients

Hayashi, Minoru MD, PhD*; Muramatsu, Hideyuki MD, PhD*; Nakano, Minoru MD, PhD; Ito, Hideaki MD, PhD; Inoie, Masukazu MS§; Tomizuka, Yosuke MD, PhD*; Inoue, Mayuko MD*; Yoshimoto, Shinya MD, PhD

doi: 10.1097/SAP.0000000000000200
Burn Surgery and Research
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In Japan, the cultured epithelial autografts “JACE” was accepted as a health insurance adaptation from January 1, 2009. We examined the extensive burn wounds in 8 patients by using a combination of autograft and JACE. After debridement, we managed the wound bed preparation by using artificial dermis. The wound bed was covered with fine tissue 2 weeks after we implanted artificial dermis and trafermin was used every day. Meshed 6:1 split-thickness autografts were placed onto the recipient wound bed under the JACE. The epidermalization was nearly complete within 3 to 4 weeks.

Results A total of 39 patients underwent medical treatment of burns. All patients burned more than 30% total body surface area (TBSA). We divided them into 2 groups. The control group consisted of 31 patient, 23 men and 8 women. They underwent operation not using JACE but only autograft. The average age of the patients was 59.61 (3.85) years. The TBSA burned in this control group was 58.94% (3.89%). Operation times were 2.16 (0.24) hours. The overall survival rate was 35.5%. The study group consisted of 8 patients, 5 men and 3 women. The average age of the patients was 56.38 (7.04) years. The TBSA burned in this study group was 51.63% (4.17%). Operation times were 4.25 (0.59) hours, and the overall survival rate in this study group was 87.5%. The average take rate of JACE was 80.0% (3.09%) 4 weeks postoperatively.

Conclusions JACE is one of the cultured epithelial autografts. Although we managed the wound bed preparation by using artificial dermis instead of cryopreserved cadaver allograft, we were able to recognize a good result from grafting JACE on meshed 6:1 split-thickness autografts. The study group observed a significant difference in operation times compared with the control group. However, this treatment contributed to reducing the area of the donor site.

From the *Department of Plastic and Reconstructive Surgery, †Advanced Medical Emergency and Critical Care Center, and ‡Department of Diagnostic Pathology, Japanese Maebashi Red Cross Hospital, Maebashi, Gunma; §Department of Research and Development, J-TEC, Gamagori, Aichi; and ∥Department of Plastic and Reconstructive Surgery, Showa University School of Medicine, Tokyo, Japan.

Received June 12, 2013, and accepted for publication, after revision, February 12, 2014.

Conflicts of interest and sources of funding: none declared.

Reprints: Minoru Hayashi, MD, PhD, Department of Plastic and Reconstructive Surgery, Japanese Maebashi Red Cross Hospital, 3-21-36, Asahi-cho, Maebashi, Gunma 371-0014, Japan. E-mail: mokkox2@yahoo.co.jp.

© 2014 by Lippincott Williams & Wilkins