• Alexander P Larsson, Kristina Briheim, Victor Hanna, Karin Gustafsson, Annika Starkenberg, Hans N Vintertun, Gunnar Kratz, and JunkerJohan P EJPELaboratory for Experimental Plastic Surgery, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Center for Disaster Medicine and Traumatology, Department of Biomedical and Clinical Sciences, Linköpin.
• Laboratory for Experimental Plastic Surgery, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Hand Surgery, Plastic Surgery and Burns, Linköping University Hospital, Linköping, Sweden. Electronic address: alexander.larsson@regionostergotland.se.
• Burns. 2021 May 1; 47 (3): 601-610.

AbstractDefinitive treatment to achieve wound healing in major burns frequently include skin transplantation, where split-thickness skin grafts is considered gold standard. This method is associated with several drawbacks. To overcome these hurdles, efforts have been made to develop tissue engineered skin substitutes, often comprised of a combination of cells and biomaterials. In the present study, we aimed to investigate transplantation of autologous keratinocytes and fibroblasts seeded on porous gelatin microcarriers using a porcine wound model. Pre-seeded microcarriers were transplanted to a total of 168 surgical full-thickness wounds (2cm diameter) on eight adult female pigs and covered with occlusive dressings. The experimental groups included wounds transplanted with microcarriers seeded with the combination of keratinocytes and fibroblasts, microcarriers seeded with each cell type individually, microcarriers without cells, each cell type in suspension, and NaCl control. Wounds were allowed to heal for one, two, four or eight weeks before being excised and fixated for subsequent histological and immunohistochemical analysis. In vitro, we confirmed that viable cells populate the surface and the pores of the microcarriers. In vivo, the microcarriers were to a large extent degraded after two weeks. After one week, all treatment groups, with the exception of microcarriers alone, displayed significantly thicker neo-epidermis compared to controls. After two weeks, wounds transplanted with microcarriers seeded with cells displayed significantly thicker neo-epidermis compared to controls. After four weeks there was no difference in the thickness of neo-epidermis. In conclusion, the experiments performed illustrate that autologous cells seeded on porous gelatin microcarriers stimulates the re-epithelialization of wounds. This method could be a promising candidate for skin transplantation. Future studies will focus on additional outcome parameters to evaluate long-term quality of healing following transplantation.Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

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