Efficacy of a Self-Made Artificial Skin in the Treatment of Chronic Ulcers

摘要

Letter to the Editor: Chronic skin ulcers are an ever-increasing pathology among outpatients of a dermatology department. Sometimes these patients require long periods in hospital with potential surgeries, which do not always help the ulcers to resolve. Tissue-engineered skin may offer new therapeutic possibilities in such patients, although its use is considerably limited by scarce availability and high cost. We present herein a patient with an excellent response to the treatment of chronic ulcers with a low-cost skin equivalent entirely designed and produced in our hospital. This prototype is based on human plasma as the main component of the dermal layer. Keratinocytes and fibroblasts are obtained from skin biopsies from organ donors. After mechanical fragmentation and double enzymatic digestion, we obtain the cells for the primary cultures. Cells coming from trypsin-EDTA digestion are cultured in the presence of le-thally irradiated 3T3 cells to generate keratinocytes. Cells coming from collagenasedigestion are cultivated without 3T3 to produce cultured fibroblasts. To obtain our skin equivalent, fibroblasts are diluted in human plasma and clot is caused in a culture flask by adding calcium chloride. The resulting dermis is then seeded with previously cultivated keratinocytes. Once keratinocytes have reached confluence, the skin prototype is detached from the flask, fixed to a gauze, and then grafted on the wound bed. A summary of the procedure can be seen in Figure 1.