Applicability and Safety of Skin Expansion Using a Skin Bioreactor: A Clinical Trial

• Main Authors: Cheol Jeong, Ho Yun Chung, Hyun Ju Lim, Jeong Woo Lee, Kang Young Choi, Jung Dug Yang, Byung Chae Cho, Jeong Ok Lim, James J Yoo, Sang Jin Lee, Anthony J Atala
• Format: Article
• Language: English
• Published: Korean Society of Plastic and Reconstructive Surgeons 2014-11-01
• Series: Archives of Plastic Surgery
• Subjects: Skin transplantation; Tissue expander devices; Cicatrix
• Online Access: http://www.e-aps.org/upload/pdf/aps-41-661.pdf
• ISSN: 2234-6163; 2234-6171

BackgroundTissue expansion is an effective and valuable technique for the reconstruction of large skin lesions and scars. This study aimed to evaluate the applicability and safety of a newly designed skin expanding bioreactor system for maximizing the graft area and minimizing the donor site area.MethodsA computer-controlled biaxial skin bioreactor system was used to expand skin in two directions while the culture media was changed daily. The aim was to achieve an expansion speed that enabled the skin to reach twice its original area in two weeks or less. Skin expansion and subsequent grafting were performed for 10 patients, and each patient was followed for 6 months postoperatively for clinical evaluation. Scar evaluation was performed through visual assessment and by using photos.ResultsThe average skin expansion rate was 10.54%±6.25%; take rate, 88.89%±11.39%; and contraction rate, 4.2%±2.28% after 6 months. Evaluation of the donor and recipient sites by medical specialists resulted in an average score of 3.5 (out of a potential maximum of 5) at 3 months, and 3.9 at 6 months. The average score for patient satisfaction of the donor site was 6.2 (out of a potential maximum of 10), and an average score of 5.2 was noted for the recipient site. Histological examination performed before and after the skin expansion revealed an increase in porosity of the dermal layer.ConclusionsThis study confirmed the safety and applicability of the in vitro skin bioreactor, and further studies are needed to develop methods for increasing the skin expansion rate.