After severe burn wounds patients are susceptible to infections, which unless properly managed can result in sepsis and dead. The current standard of care involves taking skin cells from the patient in an area that has not been injured, expanding the cells in tissue culture, and subsequently placing the cells on the area that has been burned. The drawback with this approach is that it takes about three weeks. In the interim many patients develop infections. Therefore new technologies are needed to create cells that can be ready to use in an expedient manner. A previous approach has been to use skin cells from the foreskin of infants after circumcision and expand these cells. However immune rejection occurs and these cells are not as protective as using the patient’s own cells.
A French team of scientists created human skin from stem cells and demonstrated that the skin was functional by placing it on the back of a mouse that was lacking an immune system (so to avoid rejection). The skin engrafted on the mouse and remained alive for the evaluation period of 3 months. Most strikingly, the skin was able to allow for healing of the mouse’s own epidermis. Since the skin cells were derived from stem cells, the scientists believe that they represent cells that are less visible to the immune system.
Dr. Marc Peschanski, research director at the French Research Institute I-Stem, stated" What our findings can provide is a way to cover the burns during those three weeks with skin epidermis … produced in that factory and sent to the physician at the moment they receive a severely burned patient," He continued "They call the factory and then, immediately, they will get a square meter of epidermis which will be a temporary way to cover the burns."
Stem cell therapies for burn wounds have been relatively underexplored. Previous studies have demonstrated that bone marrow stem cells can accelerate wound healing. While this approach is promising, it is difficult to perform bone marrow extraction in patients with severe burn wounds. Additionally, few hospitals have the facilities to process bone marrow cells in order to be administered on the skin.
The advantage of the work described in the publication (Guenou et al. Lancet. 2009 Nov 21;374(9703):1745-53) is that the cells can be used in a "universal donor" fashion. That is, they can be stockpiled and ready for application when the need arises.