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The use of amnion-derived cellular cytokine solution (ACCS) in accelerating closure of interstices in explanted meshed human skin grafts.

Uberti MG, Ko F, Pierpont YN, Johnson EL, Wright TE, Smith CA, Robson MC, Payne WG - Eplasty (2009)

Bottom Line: Serial wound tracings of unepithelialized interstitial wound areas were compared over time.Two different preparations of amnion-derived cellular cytokine solution were also compared with one another, one containing animal components and the other free of animal components.There were no statistical differences among the 3 amnion-derived cellular cytokine solution-treated groups.

View Article: PubMed Central - PubMed

Affiliation: Institute for Tissue Regeneration, Repair, and Rehabilitation, Bay Pines VAHCS, Bay Pines, FL, USA.

ABSTRACT

Unlabelled: Meshed, split-thickness skin grafts, especially when required to be widely spread, do not obtain immediate biologic closure. In patients with burns that cover a large percentage of the body surface area, this leaves the patient at risk for metabolic problems and life-threatening infection.

Objective: The purpose of this study was to determine whether amnion-derived cellular cytokine solution could improve epithelialization kinetics and accelerate closure of meshed skin graft interstices.

Methods: Human meshed, split-thickness skin grafts were explanted to athymic "nude" rats and treated with 3 different regimens of amnion-derived cellular cytokine solution (groups I, II, and III) or normal saline (group IV) as a control. Serial wound tracings of unepithelialized interstitial wound areas were compared over time. Two different preparations of amnion-derived cellular cytokine solution were also compared with one another, one containing animal components and the other free of animal components.

Results: Only 67.03% of interstices in control animals closed by day 9. This compared with 92.2% closure for group I, 83.72% for group II, and 90.64% for group III. Interstices in all 3 groups treated with amnion-derived cellular cytokine solution (with or without animal-derived components) closed faster statistically than in the control animals (P < .05). There were no statistical differences among the 3 amnion-derived cellular cytokine solution-treated groups.

Conclusions: These data suggest that epithelialization kinetics and interstitial closure of meshed skin grafts can be accelerated with the use of amnion-derived cellular cytokine solution, a physiologic cocktail of cytokines, and provide support for a future clinical trial.

No MeSH data available.


Related in: MedlinePlus

Epithelialization rates of 600 wounds per group: group I, amnion-derived cellular cytokine solution (ACCS) without animal-derived components, daily treatment; group II, ACCS without animal-derived components, every other day treatment; group III, ACCS containing animal-derived components, daily treatment; and group IV, saline daily. *P < .05.
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Figure 4: Epithelialization rates of 600 wounds per group: group I, amnion-derived cellular cytokine solution (ACCS) without animal-derived components, daily treatment; group II, ACCS without animal-derived components, every other day treatment; group III, ACCS containing animal-derived components, daily treatment; and group IV, saline daily. *P < .05.

Mentions: Seventeen of the animals achieved variable closure of interstices by epithelialization. The dressings were slightly adherent in 3 animals so as to possibly disrupt the new epithelium. Therefore, these 3 animals were eliminated from statistical evaluation (1 animal each from groups I, III, and IV). Because the epithelialization rate was leveling off by day 9, the animals were humanely euthanized on day 10. Only 67.03% of the interstices in control animals closed by day 9 (Fig 4). This compared with 92.2% closure for group I, 83.72% for group II, and 90.64% for group III. Interstices in all 3 groups treated with ACCS (with or without animal-derived components) closed faster statistically than in the control animals (P < .05) (Fig 4). There were no statistical differences among the 3 ACCS-treated groups. The ACCS-treated group, using ACCS prepared without any animal-derived components and applied to the grafts daily, had the greatest degree of epithelial closure of interstices (group I), although the difference was not statistically significant. The model showed comparability between ACCS prepared with media containing animal-derived components (group III) and ACCS prepared without animal-derived components (groups I and II). Histology of sections from groups I to III were identical, demonstrating that normal epithelialization occurred in all healed grafts and that interstices closed by epithelialization and not by contracture.


The use of amnion-derived cellular cytokine solution (ACCS) in accelerating closure of interstices in explanted meshed human skin grafts.

Uberti MG, Ko F, Pierpont YN, Johnson EL, Wright TE, Smith CA, Robson MC, Payne WG - Eplasty (2009)

Epithelialization rates of 600 wounds per group: group I, amnion-derived cellular cytokine solution (ACCS) without animal-derived components, daily treatment; group II, ACCS without animal-derived components, every other day treatment; group III, ACCS containing animal-derived components, daily treatment; and group IV, saline daily. *P < .05.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2664608&req=5

Figure 4: Epithelialization rates of 600 wounds per group: group I, amnion-derived cellular cytokine solution (ACCS) without animal-derived components, daily treatment; group II, ACCS without animal-derived components, every other day treatment; group III, ACCS containing animal-derived components, daily treatment; and group IV, saline daily. *P < .05.
Mentions: Seventeen of the animals achieved variable closure of interstices by epithelialization. The dressings were slightly adherent in 3 animals so as to possibly disrupt the new epithelium. Therefore, these 3 animals were eliminated from statistical evaluation (1 animal each from groups I, III, and IV). Because the epithelialization rate was leveling off by day 9, the animals were humanely euthanized on day 10. Only 67.03% of the interstices in control animals closed by day 9 (Fig 4). This compared with 92.2% closure for group I, 83.72% for group II, and 90.64% for group III. Interstices in all 3 groups treated with ACCS (with or without animal-derived components) closed faster statistically than in the control animals (P < .05) (Fig 4). There were no statistical differences among the 3 ACCS-treated groups. The ACCS-treated group, using ACCS prepared without any animal-derived components and applied to the grafts daily, had the greatest degree of epithelial closure of interstices (group I), although the difference was not statistically significant. The model showed comparability between ACCS prepared with media containing animal-derived components (group III) and ACCS prepared without animal-derived components (groups I and II). Histology of sections from groups I to III were identical, demonstrating that normal epithelialization occurred in all healed grafts and that interstices closed by epithelialization and not by contracture.

Bottom Line: Serial wound tracings of unepithelialized interstitial wound areas were compared over time.Two different preparations of amnion-derived cellular cytokine solution were also compared with one another, one containing animal components and the other free of animal components.There were no statistical differences among the 3 amnion-derived cellular cytokine solution-treated groups.

View Article: PubMed Central - PubMed

Affiliation: Institute for Tissue Regeneration, Repair, and Rehabilitation, Bay Pines VAHCS, Bay Pines, FL, USA.

ABSTRACT

Unlabelled: Meshed, split-thickness skin grafts, especially when required to be widely spread, do not obtain immediate biologic closure. In patients with burns that cover a large percentage of the body surface area, this leaves the patient at risk for metabolic problems and life-threatening infection.

Objective: The purpose of this study was to determine whether amnion-derived cellular cytokine solution could improve epithelialization kinetics and accelerate closure of meshed skin graft interstices.

Methods: Human meshed, split-thickness skin grafts were explanted to athymic "nude" rats and treated with 3 different regimens of amnion-derived cellular cytokine solution (groups I, II, and III) or normal saline (group IV) as a control. Serial wound tracings of unepithelialized interstitial wound areas were compared over time. Two different preparations of amnion-derived cellular cytokine solution were also compared with one another, one containing animal components and the other free of animal components.

Results: Only 67.03% of interstices in control animals closed by day 9. This compared with 92.2% closure for group I, 83.72% for group II, and 90.64% for group III. Interstices in all 3 groups treated with amnion-derived cellular cytokine solution (with or without animal-derived components) closed faster statistically than in the control animals (P < .05). There were no statistical differences among the 3 amnion-derived cellular cytokine solution-treated groups.

Conclusions: These data suggest that epithelialization kinetics and interstitial closure of meshed skin grafts can be accelerated with the use of amnion-derived cellular cytokine solution, a physiologic cocktail of cytokines, and provide support for a future clinical trial.

No MeSH data available.


Related in: MedlinePlus