Table 2.
Clinical use of allogeneic keratinocytes and fibroblasts in burns (NA—not available, AT—active treatment, CT—control group, DDB—deep partial-thickness burn wounds, STSG—split-thickness skin graft, CDS—cultured dermal substitute).
| Therapy | Control/Compared To | Route of Administration | Burn Characteristics | Follow Up | # of Patients | Age Range [Years] | Result | Author | Year |
|---|---|---|---|---|---|---|---|---|---|
| Allogeneic keratinocytes | |||||||||
| cultured epidermal cells | NA | sheets | second-degree burn wounds | 9 months | 3 | 25–49 | accelerated healing and an excellent cosmetic result | Hefton et al. [54] | 1983 |
| cultured allogeneic epidermal cells | NA | sheets | the donor site, second-and third-degree burn wounds | NA | 26 | 12–70 | poor growth of cells placed on full-thickness, or third-degree burns | Madden et al. [55] | 1986 |
| banked cultured human epidermal allografts | NA | grafts | donor sites and DDB | 3 months | donor site –10; DDB –10 | donor site: 12–41; DDB: 12–32 | AT–reepithelialization in about 6.9 days, CT–in an average of 11.1 days. | Rivas-Torres et al. [56] | 1996 |
| frozen cultured human allogeneic epidermal sheets | side-by-side with skin donor sites | sheets | deep and superficial partial-thickness burns | NA | 11 | NA | faster complete re-epithelialization and reduced healing time | Alvarez-Diaz et al. [57] | 2000 |
| cryopreserved cultured epidermal allografts | non-grafted areas | grafts | DDB, split-thickness skin donor sites | 1–8 years (mean: 4.75 years) | DDB–43, donor site –12 | DDB: 4–17; donor sites: 1–17 |
suppressed scar formation in both DDB and split-thickness skin donor sites | Yanaga et al. [17] | 2001 |
| allogeneic keratinocytes | split skin grafts | sheets | deep dermal hand burns | AT–mean 24,8 months; CT–mean 22 months | 16 hands–AT, 17 hands–CT | 16–80 | no statistical significant differences | Haslik et al. [58] | 2010 |
| cultured allogeneic keratinocytes | NA | sheets | STSG donor sites and deep second-degree burn wounds | NA | donor sites–59,burns–11 | 1.8–87 | complete healing in 6.4– 7 days. |
Auxenfans et al. [14] | 2014 |
| Allogeneic keratinocytes and fibroblasts | |||||||||
| meshed (1:1.5), unexpanded Apligraf® applied over meshed (≥ 2: 1) expanded autograft | meshed (≥ 2:1) expanded autograft alone or meshed (≥ 2:1) expanded autograft covered by meshed (1.5:1) unexpanded allograf | sheets | burns | 24 | 38 | 3–78 | Apligraf® sites better than the control for 22 (58%) patients | Waymack et al. [62] | 2000 |
| OrCel™ | dressing Biobrane-L® | applied to the site wound | donor sites | 6 | 82 | 1–88 | accelerated wound healing, reduced scarring | Still et al. [65] | 2003 |
| Apligraf® or Apligraf® dermis only (without epidermis) | dressings only | sheets | partial-thickness wounds | 2 | 10 | 37.01–64.59 | 4-weeks persistence of donor DNA | Hu et al. [63] | 2005 |
| Allogeneic fibroblasts | |||||||||
| allogeneic CDS overextended auto-skin graft | NA | applied repeatedly at intervals of 5–7 days on the auto-skin graft on the wound | deep burn wounds, necrotizing fasciitis | NA | 3 | 39–88 | successful take of mesh auto-skin graft and prompt epithelization | Kashiwa et al. [66] | 2004 |
| alloskin over meshed STSG | side-by-side with petroleum jelly–impregnated gauze over meshed STGS | Applied on the wound | third-degree burn wounds | 1 year | 14 | NA | reduced healing time but no difference after 1-year follow up | Moravvej et al. [67] | 2012 |