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Use of Cultivated Epidermal Allograft in Chronic Wounds: A Novel Therapeutic Alternative

INTRODUCTION: Chronic wounds represent a frequent cause of consultation for plastic and reconstructive surgeons. The use of epidermal culture stands out because they provide complete epithelialization, adequate aesthetic-functional results, and no morbidity for the patient. Epifast® is a pre-manufac...

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Detalles Bibliográficos
Autores principales: De-Luna-Gallardo, Daniel, Cahuana-Quispe, Alberto I, García-Espinoza, Jaime A, Arámbula-Sánchez, Blanca Y, Navarro-Delgadillo, Carlos I, Dávila-Díaz, Rodrigo, Erazo-Franco, Mauricio A, Costa-Dulche, Alejandro, Mena-Garza, Ana A, Morales-De-La-Cerda, Rodrigo, Flores-Soto, David, Cuervo-Vergara, Marco A, Reyes-Ibarra, Patricia Alma, Márquez-Esrpiella, Cuahutémoc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9764952/
https://www.ncbi.nlm.nih.gov/pubmed/36561401
http://dx.doi.org/10.4103/JCAS.JCAS_177_21
Descripción
Sumario:INTRODUCTION: Chronic wounds represent a frequent cause of consultation for plastic and reconstructive surgeons. The use of epidermal culture stands out because they provide complete epithelialization, adequate aesthetic-functional results, and no morbidity for the patient. Epifast® is a pre-manufactured cultured epidermal allograft derived from the amplification in vitro of human keratinocytes. MATERIALS AND METHODS: A prospective longitudinal multicenter study was carried out in four chronic wound reference centers, which were in charge of plastic and reconstructive surgery services. For a standardized wound bed preparation, the protocol synthesized by the acronym “TIME” was used. At the end of the “TIME” protocol, the pre-fabricated allograft was applied and removed 7 days after its application. RESULTS: A total of 133 patients with diagnosis of chronic wound were included in the study. The median age was 69.3 ± 13.6 years. The most common comorbidity found was diabetes mellitus type 2 in 71.4% of the patients (n = 95) and systemic arterial hypertension in 60.2% of the patients (n = 80). The most frequent location of chronic wounds was seen in the lower extremity with 45.1% (n = 60). The mean duration for it to close was 46 ± 14 days, in which they closed within the first 3 months in 93% (n = 125) of the cases. About 91.7% (n = 122) of the wounds achieved total closure. CONCLUSION: Cultured epidermal allograft, combined with a meticulous technique and an adequate selection of patients, represents a safe and effective tool for chronic wounds.