Aerosolized epidermal cell
suspension was previously found to be effective for the epithelialization of full-thickness
wounds. This
suspension is less expensive than and requires a shorter preparation time than the currently used cultured epithelial autografts. Still, convex and irregular
wounds present unfavorable conditions for homogenous dispersion of the aerosolized cell
suspension. The authors hypothesized that the addition of
fibrin glue to the
aerosol of cells would reduce cell movement and ensure homogenous dispersion of the cells, thereby promoting wound epithelialization. The objectives of the study were to evaluate the healing of
wounds with unfavorable topography after
autotransplantation of an epidermal cell
aerosol with and without
fibrin glue. Six Yorkshire piglets were studied. An epidermal
suspension was made from full-thickness groin skin.
Dispase was used to separate the epidermis from the dermis, and
trypsin was used to separate the epidermal cells from one another. Twenty-four hours later, full-thickness
wounds with unfavorable topography were created adjacent to the vertebral column of six pigs. Twelve
wounds were treated with an
aerosol of epidermal cell
suspension mixed with
fibrin glue (study group), and 12
wounds were treated with the same
suspension without the
fibrin glue (control group). The percentages of total
wound contraction and the epithelialized and nonepithelialized areas were evaluated 1, 2, 3, and 4 weeks after aerosolization. The histologic characteristics of the newly formed skin were examined by light microscopy using slides stained with
hematoxylin and
eosin. Study
wounds were characterized by central epithelialization, whereas control
wounds were characterized by peripheral epithelialization. Study
wounds contracted at a slower rate than control
wounds, but
wound size was the same in both groups after 4 weeks. The addition of
fibrin glue facilitated epithelialization: Study
wounds showed 75.5 +/- 22.4 percent (mean +/- SD) and 94.2 +/- 8.8 percent epithelialization after 3 and 4 weeks, respectively, compared with 46.3 +/- 9.5 percent and 47.9 +/- 13.1 percent epithelialization of the control
wounds at the same times. These differences between the study and control groups were statistically significant (p < 0.001, paired t test). The addition of
fibrin glue to an
aerosol of epidermal cells significantly enhances the epithelialization of
wounds with unfavorable topography in pigs.