Once created, an autograft can be kept frozen and used to generate more sheets of skin whenever needed. For these patients, who may have a limited amount of skin from which to proceed with split skin grafting, autografting may be the only way to heal skin wounds.
Such a bank of cell cultures is now available at BioSurface Technology, a Cambridge company formed by Green in 1986. Doctors who use the technique can now send epidermal cells to BioSurface and receive complete cultures within three weeks, rather than be forced to maintain their own cell culture laboratories, an expensive and time consuming task.
The Next Step
Gallico said that the next step in researching cultured skin cells is the possibility of using cells from one person to treat another, a process known as allografting. Allografts would make it possible to use cultured skin cells at all times, since a bank of cultures could be kept at any surgical center for immediate use.
"Allografts would make things much easier," says Gallico. "Right now, there's a three-week span in which we can't do anything."
The problem, says the surgeon, is that cells from one person would be rejected by the immune system of the other. Another complication, he says, is that skin donated by others might contain viruses such as HIV, which causes AIDS.
Fewkes says that researchers are investigating the possibility of using cultured epithelial cells from neonatal foreskins as an experimental dressing for leg ulcers. Scientists are also examining ways to create synthetic epidermis, based on current knowledge learned from culturing skin cells.
Gallico says that the autografts can be used as a "living laboratory" while they are being grown. Previously, researchers had used cultures to study cell physiology, and this research is continuing.
Studies may also provide clues about patterns of growth and differentiation in skin cells. A 1989 study by Carolyn C. Compton, associate professor of pathology at the Medical School and a pathologist at MGH, found that the skin of patients treated with cultured skin grafts up to five years ago had developed lower layer skin, or dermis, rather than developing scar tissue.
"The cells are evidently getting messages from the areas on which they are placed," says Gallico.