Wound coverage with cultured autologous keratinocytes: use after burn wound excision, including biopsy followup.

Cultured autologous keratinocytes (CAK) have been used in eight patients as part of their definitive treatment for burn wound closure. The CAK grafts were placed on surgically excised wounds rather than mature granulation tissue. This technique guaranteed that permanent skin coverage derived from cultured cells, and not residual epidermal cells from surviving dermis. Graft take was variable, ranging from zero in the case of one of the children to 85%. Long-term assessment noted adequate permanent coverage, confirmed by biopsy. Electron micrographs demonstrated no well formed anchoring fibrils, which may account for the graft fragility which has been reported as much as 1 year postgraft. Advantages of using CAK are that an acceptable permanent wound closure can be achieved without depending on donor site availability. An almost unlimited quantity of skin is available because the original biopsy can be expanded manyfold in the laboratory.