Table 2.

Wound healing outcomes using allogeneic epidermal TESSs in clinical studies for EB

EB subtype	References	Study type	Patients (N)	Type of TESS	Follow-up	Outcome
RDEB	[31]	Case report	1	Skin explants derived from full-thickness allografts cultured on plastic culture surface into stratified epithelia	4 months	No sign of rejection, inflammation or any significant blistering at the allograft site; however, no further follow-up to assess long-term wound closure
	[31]	Case report	1	Keratinocytes cultured on a feeder layer of murine fibroblasts into keratinocyte sheets	4 months	All wounds epithelialised at 7 days with no renewed blistering; however, no further follow-up to assess long-term wound closure
	[31]	Prospective study	6		2 weeks	4 out of the 6 allograft sites healed faster than the controls over a short 2-week follow-up. However, no change in C7 levels were observed, suggesting that allogeneic keratinocytes were promoting proliferation and migration of resident C7-mutant keratinocytes at the wound edges via the release of cytokines and growth factors
	[22]	Prospective study	10		2 weeks	Slight analgesic effect, but no functional repair
	[31]	Case report	1	Allogeneic keratinocyte sheets in conjunction with meshed split-thickness autografts	3 months	Near complete healing except for minor blisters at edges of the split-thickness autografts
DDEB	[32]	Case report	1	Allogeneic keratinocyte sheets in conjunction with meshed split-thickness autografts	8–20 months	Complete epithelialisation at each of the two grafted sites after 8 and 10 months, respectively
JEB	[56]	Case report	1	Keratinocytes cultured on a feeder layer of murine fibroblasts into keratinocyte sheets	8 months	All wounds remained completely epithelialised for 8 months; however, four grafting procedures were required. No further follow-up to assess long-term wound closure
	[31]	Case report	1		1 week	Significant epithelialisation over approximately 70% of the patient’s epidermis but only a 1-week follow-up reported. Renewed blistering and infections were observed at multiple graft sites
EBS	[23]	Case report	1	Commercially available epidermal allograft Kaloderm® (Tego Science, Seoul, Korea) consisting of allogeneic keratinocyte sheets	3 weeks	Twice-weekly grafting resulted in a wound surface reduction of 50% but only over a short 3-week follow-up period

C7 type VII collagen, DDEB dominant dystrophic epidermolysis bullosa, JEB junctional epidermolysis bullosa, RDEB recessive dystrophic epidermolysis bullosa, TESS tissue-engineered skin substitute