Severe Burns

Healing burns with skin grafts

Skin grafts have been used for centuries, although no one knew exactly why they worked until fairly recently. Skin is particularly rich in stem cells because so much skin is lost through normal wear and tear; you shed thousands, or even millions, of dead skin cells every day. In mild cuts and burns, these stem cells work to repair the damaged tissue. In severe burns, though, the stem cells in the burn area are destroyed, so doctors have to take skin from an undamaged area.

The main obstacle in skin grafts is that, currently, only the burn patient’s own skin works reliably. If doctors try to use skin from another person, the patient’s immune system eventually rejects the graft. Scientists are working on ways to grow skin that’s genetically compatible with the patient so that, even if the patient doesn’t have enough undamaged skin to use, the burns can still be treated effectively.

 

Potential for Cures (Non-Healing)

Traditionally, treatment for severe second-degree burns consists of adding insult to injury: cutting a swath of skin from another site on the same patient in order to graft it over the burn. The process works, but causes more pain for the burn victim and doubles the area in need of healing. New technology has the potential to heal burns in a way that's much less invasive than skin grafts.

 

With just a small skin biopsy and a ready-made kit, surgeons can create a suspension of the skin's basal cells–the stem cells of the epidermis–and spray the solution directly onto the burn with results comparable to those from skin grafts. The cell spray is intended to treat severe second-degree burns, in which the top two layers of skin are damaged but the subcutaneous tissue is left intact. Third-degree burns, which are more severe, still require a skin graft. The spray, already approved for use in some countries, has garnered interest from the United States Army, whose Armed Forces Institute of Regenerative Medicine is funding a trial, slated to begin before the end of this year, of more than 100 patients. [MIT Technology Review Spraying on Skin Cells to Heal Burns Nov.5, 2009]

 

In work that has implications for those with severe burns, researchers demonstrated in mice a new way to encourage skin regeneration. Artificial skin that slowly releases a stem-cell-attracting protein could improve the healing process for patients with severe burns and for diabetics with foot ulcers. Preliminary studies combining a commonly used skin substitute with a growth factor have demonstrated faster healing in mice. The animals even appear to have regenerated new tissue, rather than scar tissue. [MIT Technology Review Faster Healing Skin, April 30, 2007]

 

Skin cells genetically engineered to be resistant to bacteria could reduce infections and improve chances of survival among burn victims. A patient's skin cells, genetically modified and grown in a test tube, could provide the next generation of artificial skin. As a first step in creating such replacement skin, scientists in Cincinnati engineered bacteria-resistant skin cells in the lab and are now testing them in animals. Ultimately, they hope to produce a type of artificial skin that can sweat, tan, and fight off infection. [MIT Technology Review A Better Artificial Skin Jan. 12, 2007]