This is the first case report of long-term follow-up after applying the autologous cultured dermal substitute to establish the wound bed before split skin graft. The results suggest that application of autologous cultured cultured dermal substitute contributes to establish the high-quality wound bed for skin graft. Split-thickness skin grafts (STSGs) are the gold standard for the treatment of burn scar contracture. Young patients in particular may require additional skin grafts as they grow, and donor site for skin grafts may be limited. We applied autologous cultured dermal substitutes (CDSs) that are expected to establish a high-quality wound bed to allow thin STSGs. This is the first report of follow-up after application of autologous CDS combined with thin STSG. A male neonate suffered third-degree burns (20% of the total body surface area) on the back. After 2 years, scar contracture of the gluteal regions were released and autologous CDS were applied. Five days after the treatment, a super thin (4–6/1,000 per inch) skin grafting was performed. After 3 years, scar contracture of the back was released and autologous CDS was applied for 2 weeks. Then a split-thick graft was harvested from the same donor site. Ten years after the last operation, the width of the skin graft on his back has extended from 5–8 cm. The contour of the grafted skin is soft, smooth, and can be pinched. This long-term result shows the autologous CDS can be expected to establish the high-quality wound bed that allows thin STSG.
From the *Department of Plastic and Reconstructive Surgery, Osaka Medical College, Osaka, Japan
†Department of Plastic and Reconstructive Surgery, Moriguchi Keijinkai Hospital, Osaka, Japan.
Published online 19 June 2018.
Received for publication January 13, 2018; accepted March 19, 2018.
This study has been approved by the institutional review board of Osaka Medical College. Registration Number: 200.
The cultured dermal substitutes were provided by R&D Center for Artificial Skin, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan, under the support of the Regenerating Medical Millennium Project of the Ministry of Health, Labour, and Welfare of Japan. This study was conducted as a clinical study of the application of CDS in compliance with the ethical guidelines of Osaka Medical College. Therefore, the CDS was produced and donated without any charge.
Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.
Takashi Nuri, MD, PhD, Department of Plastic and Reconstructive Surgery, Osaka Medical College, 2–7 Daigaku-cho, Takatsuki, Osaka 569–8686, Japan, E-mail: email@example.com
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