The Usefulness of Cultured Allogenic Keratinocyte (Kaloderm(R)) for 2nd Degree Burn Patient Treatment

PURPOSE: To minimize hypertrophic scar, contraction and color mismatch on 2nd degree burn wound, the choosing of dressing method is one of the major considerations. We report the result which is performed treatment using cultured allogenic keratinocyte (Kaloderm(R)) for 2nd degree burn patients who did not want to operation. METHODS: From February 2010 to April 2011, we treated 12 patients who suffered from 2nd degree burn using cultured allogenic keratinocyte (Kaloderm(R)). We followed up the degree of epithelization and scar formation. Average follow-up time was 7.8 months (2~16 months). RESULTS: Almost wound was healed without any complication. Epithelization of wound look an average 12.9 days after Kaloderm(R) application. We conducted split-thickness skin graft in 2 patients additionally. There were no severe hypertrophic scar, contraction and color mismatch. CONCLUSION: Using cultured allogenic keratinocyte (Kaloderm(R)) for 2nd degree burn patients is simple, effective method. It can be one of alternative treatments for 2nd degree burn patients.

Comparison of Treatment Effect of the Dried Bovine Amniotic Membrane and the Cultured Allogenic Keratinocytes in the Partial Thickness Burn Management

PURPOSE: In the partial thickness burn management, despite of several advantages, the use of human amniotic membrane has been limited. The authors applied dried bovine amniotic membrane(DBAM) to overcome disadvantages of amniotic membrane for partial thickness burn and to compare the effectiveness of cultured allogenic keratinocytes(CAK) that have been recently used for the management of burn. METHODS: From August 2007 to May 2008, 16 patients with partial thickness burn were assigned to this study. The ages ranged from 12 to 59, with the average of 38. Either DBAM or CAK were applied, and the secondary dressing was removed on the following day. To compare treatment effect, time for epithelization, Vancouver scar scale and chromameteric results were evaluated. RESULTS: The time for epithelization was 10.1 days and 9.1 days in DBAM and CAK, respectively, which are shorter than the previous 2-3 weeks. At the follow up Vancouver scar scale was 2.8 in DBAM and 3.0 points in CAK, both of which showed good results. The results of chromameter showed that the L*, a*, and b* values of the area applied DBAM were 60.1, 13.6, and 13.3, respectively, and the values of the area applied CAK were 60.1, 12.4, and 12.4, respectively. It was found that the skin color of the healed area after burn was darker, the redness was higher, and the yellowness was lower. After dressing, no significant side effects were observed, and in the cases of applying CAK, it was inconvenient as the moving area had to be fixed. CONCLUSION: As CAK, DBAM has several advantages such as the shortening of the epithelization period, reduction of scar and pigmentation, and convenient application, etc., it is an effective method for the partial thickness burn management.

The Usefulnesssof Cultured Allogenic Keratinocyte for Burn Treatment

PURPOSE: When choosing dressing method to treat skin defect by second degree or higher burn, we have to consider method of rapid epithelization and minimization of pain during the treatment. In this study, we used biologic dressing with cultured allogenic keratinocytes for skin defect due to burn. We followed up the degree of epithelization, the degree of pain, and patient satisfaction. METHODS: From June 2003 to June 2006, among the patients with skin defect due to burn, 31 cases with second degree burn(moderate to severe) were selected and biological dressing with cultured allogenic keratinocytes were done. 21 cases did not use cultured allogenic keratinocytes. Most of the patients had second degree burn. We applied cultured allogenic keratinocyte by Kaloderm. For wounds that were not deep enough to effect the dermis, escharectomy was done before applying Kaloderm. After the operation, moist wound site was maintained by dressing with saline gauze for 5-7 days. We compared the condition of the wound site before and after applying Keloderm by grading epithelization by standardized percentage scoring scale(1-5), and degree of pain and patient satisfaction by visual analogue scale(0-10). RESULTS: When cultured allogenic keratinocytes were applied for the same period of time, the mean score of epithelization were 3.29+/-0.529(mean+/-S.D.). Without the application, the mean score of epithelization were 2.86+/-0.655(mean+/-S.D.). The degree of pain was 7.71+/-1.419(mean+/-S.D.) and 2.35+/-0.950(mean+/-S.D.) before and after the application, respectively. The patients' satisfaction score was 6.45+/-0.850(mean+/-S.D.) and 8.45+/-0.961(mean+/-S.D.) before and after the application, respectively. CONCLUSION: Applying biological dressing with cultured allogenic keratinocyte to skin defect due to second degree burn showed satisfactory results in the degree of the epithelization, degree of pain and patients' satisfaction.

Treatment of Partial Thickness Skin Defect with Cultured Allogenic Keratinocytes (Kaloderm.)

PURPOSE: Grafting with autograft skin remains the most effective method for treating skin defects. When insufficient donor sites are present or patients are afraid of the operation, a skin graft is impossible. Cultured allogenic keratinocytes speed wound healing by providing cover and by producing growth factors and extracellular matrix protein. We report an application of cultured allogenic keratinocytes (Kaloderm., Tegoscience, Seoul, Korea) in the treatment of an acute partial thickness skin defect. METHODS: From March 2005 to January 2006, 20 patients with a partial thickness skin defect were treated with cultured allogenic keratinocytes. The wound was covered with a sheet of cultured allogenic keratinocytes and ointment with Bactigras. gauze. The wound was inspected every two or three days. We regarded completion of epithelialization as wound healing. RESULTS: The mean period between time of injury and time of Kaloderm. application was 7.5 days. The time taken from application of Kaloderm. to complete closure of the wounds was 7.2 days. CONCLUSION: In view of the favorable outcome, cultured allogenic keratinocytes are safe and effective biologic dressing materials for use in the treatment of open wounds.