• D A Hollander, C Soranzo, S Falk, and J Windolf.
• Department of Trauma and Reconstructive Surgery, Johann Wolfgang Goethe-University, Frankfurt, Germany.
• J Trauma. 2001 Jun 1; 50 (6): 112511361125-36.

BackgroundThis report demonstrates the potential of two-stage autologous keratodermal grafting as a starting point for noninvasive reconstruction of extensive traumatic soft tissue defects.MethodsIn three severely injured patients, skin biopsies for cell cultivation were taken. Cultured "neodermis" consisting of cultured autologous fibroblasts grown on biocompatible three-dimensional scaffolds made up of benzyl ester of hyaluronan was grafted on conditioned defect areas. After ingrowth of dermal substitutes, transplantation of cultured autologous keratinocytes on hyaluronan-based laser-perforated membranes was performed. Ten days later, a 0.2-mm thin, 1:6 meshed autograft was overlaid. Clinical follow-up, histologic, and immunohistochemical findings were documented.ResultsGrafting with cultured autologous fibroblasts revealed a suitable dermal tissue replacement. Epithelialization was evident after transplantation of keratinocytes. Final closure of the defects with "normoelastic" tissue properties was achieved after thin mesh-grafting.ConclusionPreliminary findings with the described method seem to be very promising. As in all fields of tissue engineering, long-term studies and further follow-up are required.

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