Cultured Epithelial Autografts for massive burns patients

Autologous split skin grafts (SSG) remain the gold standard for management of patients with massive burns. However, autografts become insufficient to cover burn wounds when the total body surface area (TBSA) involved exceed thirty-five percent. The application of Cultured Epithelial Autograft (CEA) technology involves taking a skin sample from the burns patient, culturing and expanding the skin cells before re-applying the end product to cover the burn wounds in the same patient. The skin sample consists of an elliptical full thickness skin biopsy (2x5cm) harvested from a hair-bearing area such as groin, axilla or scalp. In certain circumstances where it is not feasible to take a full thickness skin sample from the participant for processing (ie donor hair-bearing areas such as groin, axilla and scalp are involved in the burn injury), a 2x5cm split skin biopsy may be taken (with a dermatome) instead from an available and appropriate region. Harvesting of the skin sample is anticipated to take no longer than 10-20 minutes. The exact timing of CEA application depends on factors such as wound bed preparation and patient stability. However, CEA manufactured from our Skin Culture Laboratory is ready to be applied approximately 14 days after the initial skin biopsy. All the patients will receive autologous split skin grafts, the gold standard for management of patients with massive burns. Prepared wound beds are closed as much as possible with meshed autologous split skin grafts, in particular, difficult areas susceptible to shear forces and poor graft take (posterior trunk) or areas susceptible to joint contractures (joint flexures, hands). The exact quantity of CEA produced and used in any particular patient depends on the individual clinical requirements, rate of expansion and production capabilities of the clinical laboratory.