A randomized, double-blind, phase I clinical trial of fetal cell-based skin substitutes on healing of donor sites in burn patients. Issue 4 (June 2019)

• Record Type: Journal Article
• Authors: Momeni, Mahnoush; Fallah, Nasrin; Bajouri, Amir; Bagheri, Tooran; Orouji, Zahra; Pahlevanpour, Parisa; Shafieyan, Saeed; Sodeifi, Niloofar; Alizadeh, Ahad; Aghdami, Nasser; Fatemi, Mohammad Javad
• Is Part Of: Burns. Volume 45:Issue 4(2019)
• Page Start: 914
• Page End: 922
• Publication Date: 2019-06
• Subjects: Burn -- Stem cell -- Tissue engineering -- Wound healing; Burns and scalds -- Periodicals; 617.11
• DOI: 10.1016/j.burns.2018.10.016
• Languages: English
• ISSNs: 0305-4179

Abstract

Highlights: Ten patients with total burn surface area of 10–55% were enrolled in this study. Three parts in donor site of each patient were randomly covered by Vaseline gauze, amniotic membrane, or fetal cell-based amniotic membrane. Transplantation of fetal cell-based amniotic membrane in burn's donor sites was safe and tolerable. AM and AM-F groups revealed more accelerated wound healing rate and lower inflammation. No benefits were observed for fetal cell-based amniotic membrane over amniotic membrane alone in burn's donor sites. Abstract: Background: Due to limited graft donor sites in extensive burns, re-harvesting of a single donor area is very common. Given the importance of fetal fibroblasts in accelerating fetal wound healing, fetal cell-based skin substitutes have emerged as a novel therapeutic modality for regenerating damaged skin. In this trial, we aimed to evaluate the safety, feasibility and potential efficacy of application of amniotic membranes seeded with fetal fibroblasts for accelerating donor sites healing in burn patients. Methods: In this randomized, double-blind, phase I clinical trial, 10 patients with total burn surface area of 10–55% were enrolled. Three equal parts (10 × 10 cm) were selected in donor site of each patient and covered by Vaseline gauze (control group), amniotic membrane (AM group), or amniotic membrane seeded with fetal fibroblasts (AM-F group). Adverse events, pain intensity scores, and wound sizes were recorded on days 4, 8, 11, 14, and 20 post-treatment. Also, histological assessments were done on days 0 and 14 after the surgery. Results: All patients underwent surgery, and no adverse events occurred during the procedure and follow-up period. Significantly lower pain intensity and higher healing rates were observed in AM-F and AM groups compared to the control group. Moreover, mean complete re-epithelializatin in AM-F and AM groups were 10.1 ± 2.4 and 11.3 ± 2.9 days, showing that the healing process was significantly accelerated compared to the control group with mean closure time of 14.8 ± 1.6 days. Histological assessment showed lower inflammatory cells infiltration in AM-F and AM groups compared to control group. Conclusions: This study indicated the safety of transplantation of amniotic membrane seeded with fetal fibroblasts for treatment of donor sites in burn patients; however, preliminary assessments showed no benefits for this therapeutic modality over amniotic membrane alone. Thus, to draw accurate conclusions, further trials in larger populations should be conducted. Level of Evidence: This study is assigned as level I.