Cell-spray auto-grafting technology for deep partial-thickness burns: Problems and solutions during clinical implementation.

Cell-spray autografting is an innovative early treatment option for deep partial-thickness burn wounds. As an alternative to non-operative management, cell-spray autografting can achieve rapid wound re-epithelialization, particularly in large wounds. When compared to traditional mesh autografting for deep partial-thickness burn wounds, cell-spray autografting can accomplish re-epithelialization with a much smaller donor site. In this review, we describe the development of a biomedical engineering method for isolation and immediate distribution of autologous, non-cultured, adult epidermis-, and adult dermis-derived stem cells. We present data on cell isolation procedures in 44 patients with deep partial-thickness burns performed over five years under an innovative practice IRB. Treated patients presented with a variety of burn wound etiologies and a wide range of TBSA. Overall clinical results were very satisfying. The average hospital length of stay following treatment was seven days. Over the time period, the donor-site to burn-wound surface area ratio was enhanced from 1:80 to 1:100. A detailed analysis of all process-related biotechnology and operative problems, pitfalls, and solutions was performed and is reported herein. Strategies for future clinical studies are discussed.

Second-degree burns with six etiologies treated with autologous noncultured cell-spray grafting.

Partial and deep partial-thickness burn wounds present a difficult diagnosis and prognosis that makes the planning for a conservative treatment versus mesh grafting problematic. A non-invasive treatment strategy avoiding mesh grafting is often chosen by practitioners based on their clinical and empirical evidence. However, a delayed re-epithelialization after conservative treatment may extend the patient's hospitalization period, increase the risk of infection, and lead to poor functional and aesthetic outcome. Early spray grafting, using non-cultured autologous cells, is under discussion for partial and deep partial-thickness wounds to accelerate the re-epithelialization process, reducing the healing time in the hospital, and minimizing complications. To address planning for future clinical studies on this technology, suitable indications will be interesting. We present case information on severe second-degree injuries after gas, chemical, electrical, gasoline, hot water, and tar scalding burns showing one patient per indication. The treatment results with autologous non-cultured cells, support rapid, uncomplicated re-epithelialization with aesthetically and functionally satisfying outcomes. Hospital stays averaged 7.6±1.6 days. Early autologous cell-spray grafting does not preclude or prevent simultaneous or subsequent traditional mesh autografting when indicated on defined areas of full-thickness injury.

Superior anticarcinogenic activity of trans,trans-conjugated linoleic acid in N-methyl-N-nitrosourea-induced rat mammary tumorigenesis.

The anticarcinogenic activity of a mixture of trans,trans-conjugated linoleic acid (trans,trans-CLA) was investigated in rat mammary tumorigenesis induced by N-methyl-N-nitrosourea (MNU), with references to cis-9,trans-11-CLA and trans-10,cis-12-CLA isomers. Female, 7-week-old Sprague-Dawley rats were intraperitoneally injected with MNU (50 mg/kg of body weight) and then subjected to one of five diets (control, 1% trans,trans-CLA, 1% cis-9,trans-11-CLA, 1% trans-10,cis-12-CLA, and 1% linoleic acid; 8 rats/group) for 16 weeks. Food and water were made available ad libitum. trans,trans-CLA significantly (p < 0.05) reduced tumor incidence, number, multiplicity, and size and significantly (p < 0.05) increased apoptosis, relative to cis-9,trans-11-CLA and trans-10,cis-12-CLA. The molecular mechanism of trans,trans-CLA was elucidated by measuring apoptosis-related gene products and fatty acid composition in tumors. trans,trans-CLA led to increases in the p53 protein and Bax protein levels but suppressed the expression of Bcl-2 protein. The activation of caspase-3 led to the cleavage of poly(ADP-ribose) polymerase, which resulted in the execution of apoptosis. In addition, trans,trans-CLA reduced cytosolic phospholipase A2, cyclooxygenease-2, and peroxisome proliferator-activated receptor gamma protein levels. These results suggest that the trans,trans-CLA inhibits MNU-induced rat mammary tumorigenesis through the induction of apoptosis in conjunction with the reduction of arachidonic acid metabolites and that the efficacy of trans,trans-CLA is superior to cis-9,trans-11-CLA and trans-10,cis-12-CLA.