A novel combination of keratinocyte and autologous microskin grafting to repair full thickness skin loss

The high mortality of patients with extensive deep burns is mainly attributed to the extensive burn wound and scarce autologous skin left for wound repair. The purpose of this study is to explore how to effectively use the limited remaining autologous skin to repair the extensive deep wound. Human keratinocytes harvested from the foreskin were cultured and transfected with epidermal growth factors (EGF) by adenovirus vector (Ad-EGF). Rats were subjected to a full thickness skin loss (3.3cmx3.0cm) on the dorsum, which was repaired with the EGF gene-modified human keratinocyte suspension and autologous microskin and covered with allogeneic skin. The results showed that the EGF gene-modified human keratinocytes highly expressed EGF. CK10, CK14, and CK19 as keratinocyte differentiation markers were elevated in the EGF gene-modified human keratinocytes. Wound healing was accelerated remarkably by the combination of autologous microskin grafting and EGF gene-modified human keratinocytes in vivo. The results suggested that the EGF gene-modified human keratinocyte suspension may serve as promising seed cells which can effectively secrete EGF to accelerate wound repair in combination with autologous microskin grafting and reduce the amount of autologous skin required for wound repair.