Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 1, January, p. 5–10

doi: 10.17219/acem/76327

Publication type: original article

Language: English

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Does the transplantation of keratinocytes really reduce the risk of death? Survival analysis of patients hospitalized at the Dr Stanisław Sakiel Centre for Burns Treatment in 2008–2015

Diana Kitala1,2,A,B,C,D, Agnieszka Klama-Baryła1,C, Małgorzata Kraut1,D, Dariusz Łowicki1,B, Wojciech Łabuś1,D, Justyna Glik1,3,E,F, Marcelina Misiuga1,4,B,D, Mariusz Nowak1,E,F, Grażyna Lisowska5,F, Raphael Olszewski6,E, Marek Kawecki1,7,A,E,F

1 Dr Stanisław Sakiel Centre for Burns Treatment, Siemianowice Śląskie, Poland

2 Silesian Higher Medical School, Katowice, Poland

3 Department of Chronic Wounds Management Organization, School of Health Sciences, Medical University of Silesia, Katowice, Poland

4 Silesian Analytical Laboratories, Katowice, Poland

5 Department and Clinical Ward of Otolaryngology and Laryngological Oncology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland

6 Department of Oral and Maxillofacial Surgery, University Hospital St. Luc, Catholic University of Leuven, Brussels, Belgium

7 Department of Emergency Medicine, School of Health Sciences, University of Bielsko-Biala, Poland

Abstract

Background. Keratinocyte transplantation is an adjuvant procedure in the extensive burn therapy method. However, it must be taken into consideration that clinical results of keratinocyte transplantation are ambiguous and progress achieved in this method is still being verified, especially due to the high cost of cultured epithelial autograft (CEA) transplants.
Objectives. The aim of this study was to verify the impact of cultured keratinocyte application on patients’ survival. This study included a group of patients with the highest chance for a successful outcome of the therapy and excluded patients with no compelling reason to apply for such an expensive therapy.
Material and Methods. This study included all the patients with burns diagnosed between January 1, 2008 and January 1, 2016, who were treated with cultured skin cells. Patients’ age and gender, percentage of total body surface area (TBSA) affected, percentage of burn depth of the 3rd/4th degree, number of days between admission and surgery, and need for rehabilitation were analyzed.
Results. The cultured cell application did not significantly affect the risk of death (p > 0.05).
Conclusion. Keratinocytes should be applied as an adjunctive method for the treatment of burns with at least 40% TBSA affected, but with a maximal burn depth of the 2nd degree. In the group of patients below 50 years of age, a higher number of transplants with a cell population above 20 million/mL and a significantly lower mortality rate were observed, which means that in the mentioned age group, this graft was more effective. It has been suggested that patients older than 50 years of age with burns deeper than of the 2nd degree should be treated with more advanced methods like, e.g., the application of stem cells.

Key words

burn, keratinocytes, advanced therapy medicinal product, cell graft

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