A clinical trial at Melbourne's Alfred Hospital is evaluating the safety and efficacy of engineered skin for patients with severe burns covering at least 20% of their body. Researchers are using a patient's own skin cells to grow new skin in the lab, which is then grafted onto the burn site.
Lab-Grown Skin: A New Hope for Burn Victims
The process involves taking a small sample of healthy, unburnt skin from the patient and using it to grow billions of new skin cells in the lab's incubators. These cells are then suspended in sheets made of strong but supple hydrogel and surgically grafted onto the patient. "The results have been really positive and encouraging," said Dr. Shiva Akbarzadeh from Monash University, who leads the research team. "Most wounds were closed within two weeks with little sign of early scarring."
Addressing the Limitations of Traditional Autografts
Traditional treatment for severe burns involves autografts, where a thin layer of skin is taken from an unaffected part of the body and grafted onto the burn site. However, this method is not always possible for patients with extensive burns. Even when autografts are successful, they can lead to scarring that restricts movement and affects a person's quality of life. For older individuals, healing from autografts can also be a significant challenge.
The Science Behind Engineered Skin
Engineered skin sheets offer a potential solution by reducing or eliminating the need for autografts. These sheets are created by taking a small sample of healthy skin from a patient, encouraging the cells to multiply, and then suspending them in sheets to be grafted. One challenge with engineered skin is vascularization, which is the process of getting the body's blood vessels to grow into the graft and provide nutrients to the cells. Dr. Akbarzadeh's hydrogel sheets, made from donated platelets, not only hold the skin cells in place but also promote vascularization and possess antibacterial properties.
Overcoming Challenges and Future Directions
Another challenge is the time it takes to produce enough skin cells for the grafts, which can take four to six weeks. During this time, surgeons use a synthetic dressing called "biodegradable temporising matrix" (BTM) to cover the deep burns. BTM acts like the dermis and buys time for the engineered skin to be produced. Researchers are also exploring ways to improve burn healing, such as using Botox to reduce hypertrophic scarring and cell rejuvenation to speed up graft production.
The Future of Burn Treatment
While engineered-skin trials are promising, there's still a way to go before such grafts are completely indistinguishable from a person's own skin. "Every skin lab around the world is working on the Holy Grail—producing skin that is functionally and physiologically viable and has pigmentation, hair follicles, and sweat glands," said Dr. Bronwyn Dearman, principal medical scientist at the Royal Adelaide Hospital's skin engineering laboratory.
