Sperry Micro-Coring System: Automated Full-Thickness Skin Microcolumns in Dermal Regeneration Templates for Donor-Free Skin Renewal in Prolonged Field Care
Abstract
Background, rationale, and purpose of study: The proposed application is submitted in response to the following FY20 MBRP CTRA Focus Area: burn care solutions for use by a non-medical first responder in a PFC scenario. Current standard-of-care coverage of a large full-thickness skin defect is split-thickness skin graft (STSG). However, STSG donor sites can be associated with significant pain and scarring, and injured sites often do not regain full skin function after healing. Full-thickness skin microcolumn (FTSM) harvest aims to provide a skin replacement strategy that does not suffer from these drawbacks. As the skin columns are full-thickness, they contain elements from all skin layers, including hair follicles and sweat glands, which enable the injured area to be functional once healed. In addition, the donor sites for FTSM have been shown to heal more quickly and with less scarring as compared to STSG in the preclinical setting. We expect healing following FTSM to occur faster than the two weeks generally allowed for STSG healing for military and civilian patients alike. In this study, we aim to further examine the manual FTSM method as well as develop and validate an automated technique for FTSM harvest. Patients in the San Antonio area admitted to the USASIR, BAMC, or Baptist or Methodist Health System hospitals with open wounds needing skin coverage will be considered for enrollment. Following treatment, patients will be seen weekly and healing donor sites assessed for re-epithelialization, pigmentation, contraction, scar volume, and pain. Healing injured areas will be assessed for re-epithelialization, pigmentation, contraction, and scar thickness as well. Objectives: (1) Acquire additional data on the healing of the injured and donor sites following manual FTSM harvest and implantation into a dermal scaffold. (2) Evaluate an automated process during which the Sperry Micro-coring System (SMS) or an automated device representative of the SMS device will be used to harvest FTSMs, position FTSMs within a dermal scaffold, and then place the seeded template onto wounds. This process will be compared to the standard-of-care STSG. Military and civilian healthcare impact: In prolonged field care scenarios (PFC), the use of STSGs is limited and skin replacement deferred until the Soldier can be evacuated to a higher level of care. In future large-scale combat operations (LSCO), loss of air superiority is anticipated, as well as an increase in the number of burn injuries due to advanced weaponry such as precision fires, thermobaric weapons, and directed-energy weapons. Loss of air superiority could result in significantly longer periods prior to evacuation of Soldiers to higher levels of care. This delay can cause healing complications such as hypertrophic scarring, contracture, and chronic pain. As FTSM harvest does not create a new, large, open wound, this method would allow skin replacement to be performed on the ground following non-surgical debridement, resulting in faster treatment and fewer complications. Additionally, automating this process would simplify a procedure already able to be performed by non-medical personnel. The device proposed for use in this study is one-time use, disposable, handheld, and lightweight, all factors that make it the ideal tool for skin harvest in LSCO. Civilians also suffer from large wounds requiring skin replacement. At times, patients with larger wounds or extensive injuries do not have enough healthy skin to serve as the donor site. Additionally, the meshing required for STSG creates an unappealing fish-net appearance once healed. FTSM is a promising method that addresses the pitfalls of STSG harvest and has the potential to revolutionize skin replacement therapy as we know it.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 05, 2021
- Source ID
- W81XWH2110852
Entities
People
- Rodney K Chan
Organizations
- United States Army
- United States Army Institute of Surgical Research