Wound Healing Concept for Burn Disease Patients

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Jörg C. Gerlach, MD, PhD

McGowan Institute for Regenerative Medicine, University of Pittsburgh, PA

There is a clinical need for improved therapy of burn victim patients, for example soldiers who received extreme traumatic burns in the line of duty. Victims suffering from full thickness -3rd degree- burns often die, because the therapy of choice (surgical skin mesh auto grafting) is limited by the availability of healthy skin cell area.


Biotechnology and tissue engineering methods lead to the use of skin cell cultures, taken from the patient’s healthy skin areas and expanded to cell sheets in Petri dishes. These methods, however, are not yet advanced enough to help in more severe cases. Pathophysiologic problems include serous fluid blisters between the transplanted tissue sheets and the wound and the subsequent loss of cell areas, non optimal cell nutrition in the early phase after cell transfer, water- and electrolyte dearrangements in the wound, toxin accumulation, and pH dearrangements. Consequently the biomatrix in the wound is unphysiological, and the transplant cell-sheet grafting and required cell proliferation in the wound is not optimal. Furthermore, the transplanted keratinocytes only produce a very thin neo-skin with low protective quality.

Wound Healing Concepts for Burn Disease Patients

Dr. Gerlach’s group is developing several regenerative medicine approaches to overcome these problems:

• Use of the connective tissue skin fibroblast cells additionally and in parallel to skin keratinocytes, allowing better tissue reorganization in the wound (cell biology approach).
• Reduction of in vitro culture time to prevent differentiation of the basal keratinocytes in the in vitro phase. A faster and earlier therapy start is possible by islet-like distribution of single cells in the wound (cell application approach).
• Application of the “tissue engineering in the wound“ approach, enabled by the use of a temporary hollow fiber membrane capillary bed, perfused with oxygenated nutrition and dialysis medium (wound healing approach), also allowing drug delivery supporting wound healing and antibiotic therapy to address infections. These capillaries are placed during the initial two days above the sprayed cells and below the wound dressing (biotechnology approach).

The technology and method developments are based on preliminary work, performed by Dr. Gerlach at the Berlin University Hospital, Germany and the Berlin Burn Clinic. Since the foundation work for the clinical experience has been established with the novel therapy concept, it is possible that a clinical plan to treat burn victims can be developed expeditiously based on this existing groundwork. The project includes collaboration with the Charité, Berlin Medical Faculty of the Berlin Universities and Hybrid Organ, Berlin, Germany.