Two innovative products under development with DoD funding promise a stunning transformation in the way burns are treated and how they heal.
Usual burn treatment involves harvesting healthy skin from the unburned areas of the patient’s skin, an extremely painful procedure. However, with ReCell (Avita Medical, Cambridge, United Kingdom), surgeons instead take a smaller sample of healthy skin (about the size of 1 or 2 postage stamps) and create a suspension of individual skin cells. Within 30 minutes, the suspension, which is sprayed on, can be used to treat a skin wound 80 times larger than the sample taken.
ReCell speeds healing and improves the appearance of scars, the manufacturer says. The disaggregated cells behave like those at an acute wound‘s edge: The suspension introduces the cell signaling associated with wound healing across the surface area of the wound. Melanocytes included in the spray progressively deposit melanin over several months, and the normal pigmentation gradually returns.
StrataGraft (Stratatech Corporation, Madison, WI), intended for more severe burns, is a living product designed to mimic natural human skin, with both dermal and fully differentiated epidermal layers. Unlike first-generation products, the manufacturer says, this resorbable tissue is easily sutured or stapled and remains intact in the wound bed.
In a 2014 clinical trial of 28 patients with second-degree, deep, partial-thickness burns, 27 achieved complete wound closure by day 90 with a single application of StrataGraft tissue; the 28th patient’s wound closed in the following weeks. No StrataGraft DNA was detectable at day 90, which the manufacturer says confirmed that the patients had regenerated their own skin.
StrataGraft could be lifesaving for patients whose extensive injuries don’t allow for skin grafts from their own bodies in a single procedure. Those patients must wait for the donor sites to reheal before more skin can be taken. In the meantime, their burns are covered with cadaver skin or synthetic dressings, which the body typically rejects after 2 weeks. By contrast, StrataGraft would offer a ready-to-use supply of virus-free tissue.
ReCell has already been used under special compassionate use dispensations on U.S. personnel wounded in Afghanistan. Wendy Dean, MD, medical advisor for the Tissue Injury and Regenerative Medicine Program Management Office, which is monitoring the progress of the 2 treatments, says they could lead to a “paradigm shift” in skin injury treatment.