Model to Inhibit Contraction in Third-Degree Burns Employing Split-Thickness Skin Graft and Administered Bone Marrow-Derived Stem Cells

Author:

Rodriguez-Menocal Luis1ORCID,Davis Stephen C2,Guzman Wellington1,Gil Joel2,Valdes Jose2,Solis Michael2,Higa Alexander2,Natesan Shanmugasundaram3,Schulman Carl I4,Christy Robert J3,Badiavas Evangelos V1

Affiliation:

1. Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery/Interdisciplinary/Stem Cell Institute, University of Miami School of Medicine , Miami, Florida , USA

2. Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine , Miami, Florida , USA

3. Extremity Trauma and Regenerative Medicine Program, US Army Institute of Surgical Research , Texas , USA

4. Department of Surgery, Ryder Trauma Center, University of Miami School of Medicine , Miami, Florida , USA

Abstract

Abstract Third-degree burns typically result in pronounced scarring and contraction in superficial and deep tissues. Established techniques such as debridement and grafting provide benefit in the acute phase of burn therapy, nevertheless, scar and contraction remain a challenge in deep burns management. Our ambition is to evaluate the effectiveness of novel cell-based therapies, which can be implemented into the standard of care debridement and grafting procedures. Twenty-seven third-degree burn wounds were created on the dorsal area of Red Duroc pig. After 72 h, burns are surgically debrided using a Weck knife. Split-thickness skin grafts (STSGs) were then taken after debridement and placed on burn scars combined with bone marrow stem cells (BM-MSCs). Biopsy samples were taken on days 17, 21, and 45 posttreatment for evaluation. Histological analysis revealed that untreated control scars at 17 days are more raised than burns treated with STSGs alone and/or STSGs with BM-MSCs. Wounds treated with skin grafts plus BM-MSCs appeared thinner and longer, indicative of reduced contraction. qPCR revealed some elevation of α-SMA expression at day 21 and Collagen Iα2 in cells derived from wounds treated with skin grafts alone compared to wounds treated with STSGs + BM-MSCs. We observed a reduction level of TGFβ-1 expression at days 17, 21, and 45 in cells derived from wounds treated compared to controls. These results, where the combined use of stem cells and skin grafts stimulate healing and reduce contraction following third-degree burn injury, have a potential as a novel therapy in the clinic.

Funder

U.S. Department of Defense

Publisher

Oxford University Press (OUP)

Subject

Rehabilitation,Emergency Medicine,Surgery

Reference37 articles.

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4. Prevalence of scar contractures after burn: a systematic review;Oosterwijk;Burns,2017

5. Strategies demonstrating efficacy in reducing wound contraction in vivo;Sharpe;Adv Wound Care,2013

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