期刊
ANNALS OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND
卷 99, 期 6, 页码 432-438出版社
ROYAL COLL SURGEONS ENGLAND
DOI: 10.1308/rcsann.2017.0110
关键词
Skin graft replacement; Composite cultured skin; Bioreactor; Biodegradable temporising matrix; Biodegradable polyurethane
类别
资金
- BTM (Tim Moore at PolyNovo, and Marcus Wagstaff and Yugesh Caplash at the Royal Adelaide Hospital)
- CCS (Bronwyn Dearman and Amy Li of the Skin Engineering Laboratory at the Royal Adelaide Hospital, David Robertson at Icarus Design and Andre Mielke at Apexus Engineering)
- BioInnovationSAl (now TechInSA)
- South Australian Lifetime Support Authority
The skin graft was born in 1869 and since then, surgeons have been using split skin grafts for wound repair. Nevertheless, this asset fails the big burn patient, who deserves an elastic, mobile and robust outcome but who receives the poorest possible outcome based on donor site paucity. Negating the need for the skin graft requires an autologous composite cultured skin and a material capable of temporising the burn wound for four weeks until the composite is produced. A novel, biodegradable polyurethane chemistry has been used to create two such products. This paper describes the design, production, optimisation and evaluation of several iterations of these products. The evaluation has occurred in a variety of models, both in vitro and in vivo, employing Hunterian scientific principles, and embracing Hunter's love and appreciation of comparative anatomy. The process has culminated in significant human experience in complex wounds and extensive burn injury. Used serially, the products offer robust and elastic healing in deep burns of any size within 6 weeks of injury.
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