Cultured Epithelial Autografts in the Treatment of Facial Skin Defects: Clinical Outcome

Kim, Doris Maria; Schwerdtner, Oliver; Schmidt-Westhausen, Andrea-Maria; Kage, Andreas; Klein, Martin

doi:10.1016/j.joms.2005.12.070

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 65, Issue 3 , Pages 439-443, March 2007

Cultured Epithelial Autografts in the Treatment of Facial Skin Defects: Clinical Outcome

Doris Maria Kim, MD
- Resident, Department of Oral and Maxillofacial Surgery, Clinical Navigation and Robotics, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Address correspondence and reprint requests to Dr Kim: Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Department of Oral and Maxillofacial Surgery, Clinical Navigation and Robotics, Augustenburger Platz 1, 13353 Berlin, Germany
Oliver Schwerdtner, MD, DMD
- Oral-Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Clinical Navigation and Robotics, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Andrea-Maria Schmidt-Westhausen, DMD
- Department Head, Department of Oral Surgery and Dental Radiology, Zentrum für Zahnmedizin, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Andreas Kage, MD
- Attending Physician, Institute of Laboratory Medicine and Pathobiochemistry, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Martin Klein, MD, DMD
- Assistant Medical Director, Department of Oral and Maxillofacial Surgery, Clinical Navigation and Robotics, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Purpose

To report the treatment of facial skin defects by cultured epithelial autografts and its clinical outcome.

Patients and Methods

Between 2002 and 2003, 18 patients with secondary facial skin defects (after tumor excision, trauma, or due to chronic wound healing dysfunction) were successfully treated with autologous cultivated keratinocytes. Overall, 12 patients were included in our study. At the time of this evaluation, the average time lapse after treatment with autologous cultivated keratinocytes was 13.1 months. From 9 of 12 patients a skin biopsy was taken, 12 of 12 patients were neurologically tested, and the results of 12 of 12 patients’ esthetics were evaluated by photography and in written form with a standardized questionnaire.

Results

Histologically, 9 of 12 patients showed a regular epithelial layer with evidence of basal cells of the basal membrane and conspicuously arranged connective tissue. The neurologic quality of the skin was discreetly reduced in 9 of 12 patients, but this was not experienced by the patient as a limitation. The wound closure was permanent in the case of all 12 patients. Scar tissue was found frequently, when the wound size was greater than 2.5 cm². On the basis of the standardized questionnaire, 12 of 12 patients rated the degrees of their subjective satisfaction.

Conclusion

From the esthetic, histologic, and neurologic points of view, cultured epithelial autografts are an auspicious alternative to conventional grafting methods for facial skin replacement. Optimizing cell growth in vitro to decrease the cultivation period still remains an essential goal for the future to increase patient acceptance of the procedure as well.