Clinical Studies

The normal function of the skin is to provide an effective barrier to prevent fluid loss from the body and to stop infection from getting in from the outside. In patients suffering from burn injuries, this barrier is lost and there is the possibility of both fluid loss and infection. If the burn is not too extensive, the standard treatment is to graft skin from non-burned areas. However, if a larger proportion of skin has been burnt, there will be insufficient areas from which grafts can be harvested. Ultimately, the protective barrier given to the patient must be replaced with the patient's own cells and tissues.

Full thickness burns

We are actively researching new ways in which a burns patient's own cultured skin cells (keratinocytes) can be combined with a limited area of donor sites and have recently pioneered the technology of 'sprayed cells' combined with some of the patient’s own skin, which is meshed to increase coverage. With this method, the cultured keratinocytes are harvested as a liquid suspension and the cells sprayed onto the wound bed filling the gaps in between the meshed skin graft. In collaboration with surgeons at Queen Victoria Hospital burn patients have been treated in this way. The sprayed cells have been found to fill the large gaps between small pieces of skin, helping to close the wounds quickly and contributing to saving the patient's life.

Childhood scalds

A large number of young children are admitted to hospital every year with burns resulting from the spillage of a hot drink or a pan of water. The burns that result can lead to unsightly scarring. A previous study has shown that if these wounds do not heal within 3 weeks then scar tissue is formed; however if the burn is healed within 3 weeks scarring generally does not occur. In this study children who have suffered from a scald injury but have not healed by 3 weeks are treated with sprayed cultured keratinocytes, as described above. We can then evaluate how these children go on to heal and so assess the effectiveness of the treatment.

Reconstruction of the eye surface

The cornea, the area over the coloured part of the eye, is normally covered with a thin layer of "epithelial" cells similar to skin cells and as in the skin, the outer layer of cells are constantly shed and replaced from its surface. Due to damage from injuries or disease, the ability of the eyes to produce replacement corneal epithelial cells may be impaired. The cornea becomes cloudy, the vision deteriorates and the patient experiences considerable discomfort. A standard corneal graft will only temporarily replace the surface cells, as there will be no new cells to replace the old cells once they are shed.

Scientists at the Research Foundation have worked to provide ophthalmic surgeons with sheets of corneal epithelial cells to graft onto the patient's cornea, in order to stabilize and protect the cornea surface with new cells. Often, the source of cells is a small biopsy the size of a pin-head from the patients other eye, providing this is healthy and not damaged. In other cases, the tissue may come from a close relative or from eyes donated to the Queen Victoria Hospital Eye Bank. In all cases, cells from the small tissue sample are grown in culture and then grafted onto the eye of the patient. The treatment has now been extended to many patients suffering from serious corneal surface disease who have been treated in collaboration with consultant surgeons at Queen Victoria Hospital and other centres.