Severe burns in children are conventionally treated with split-thickness skin autografts or epidermal sheets. However, neither early complete healing nor quality of epithelialization is satisfactory. An alternative approach is to graft isolated keratinocytes. We evaluated paediatric foreskin and auricular skin as donor sources, autologous keratinocyte transplantation, and compared the graft efficiency to the in vitro capacities of isolated keratinocytes to divide and reconstitute epidermal tissue. Keratinocytes were isolated from surgical samples by enzymatic digestion. Living cell recovery, in vitro proliferation and epidermal reconstruction capacities were evaluated. Differentiation status was analysed, using qRT–PCR and immunolabelling. Eleven children were grafted with foreskin-derived (boys) or auricular (girls) keratinocyte suspensions dripped onto deep severe burns. The aesthetic and functional quality of epithelialization was monitored in a standardized way. Foreskin keratinocyte graft in male children provides for the re-epithelialization of partial deep severe burns and accelerates wound healing, thus allowing successful wound closure, and improves the quality of scars. In accordance, in vitro studies have revealed a high yield of living keratinocyte recovery from foreskin and their potential in terms of regeneration and differentiation. We report a successful method for grafting paediatric males presenting large severe burns through direct spreading of autologous foreskin keratinocytes. This alternative method is easy to implement, improves the quality of skin and minimizes associated donor site morbidity. In vitro studies have highlighted the potential of foreskin tissue for graft applications and could help in tissue selection with the prospect of grafting burns for girls. Copyright © 2013 John Wiley & Sons, Ltd.

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Foreskin-isolated keratinocytes provide successful
extemporaneous autologous paediatric skin grafts
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Jiad N. Mcheik1,2,
Christine Barrault3,
Nathalie Pedretti3,
Julien Garnier3,
Franck Juchaux3,
Guillaume Levard1,
Franck Morel2,
Jean-Claude Lecron2,4,*,
François-Xavier Bernard2,3
Article first published online: 14 MAR 2013
DOI: 10.1002/term.1690
Copyright © 2013 John Wiley & Sons, Ltd.
Issue
Journal of Tissue Engineering and Regenerative Medicine
Early View (Online Version of Record published before inclusion in an issue) (/journal/10.1002/(ISSN)19327005/earlyview)
Additional Information
How to Cite
Mcheik, J. N., Barrault, C., Pedretti, N., Garnier, J., Juchaux, F., Levard, G., Morel, F., Lecron, J.-C. and Bernard,
F.-X. (2013), Foreskin-isolated keratinocytes provide successful extemporaneous autologous paediatric skin grafts.
J Tissue Eng Regen Med. doi: 10.1002/term.1690
Author Information
1
Service de Chirurgie Pédiatrique, CHU de Poitiers, France
2
Laboratoire Inflammation, Tissus Epithéliaux et Cytokines (LITEC), Université de Poitiers, France
3
BIOalternatives, Gençay, France
4
Laboratoire d'Immunologie et Inflammation, CHU de Poitiers, France
http://onlinelibrary.wiley.com/doi/10.1002/term.1690/abstract;jsessionid=ACFED062B1A58E9AEB0...
17/02/2014

2. Foreskin-isolated keratinocytes provide successful extemporaneous autologous paediatric skin grafts -... Page 2 sur 2
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Correspondence to: J.-C. Lecron, Laboratoire Inflammation, Tissus Epithéliaux et Cytokines (LITEC), EA 4331,
Université de Poitiers, B36, PBS, 2 Rue Georges Bonnet, 86022 Poitiers, France. E-mail: jeanclaude.lecron@univ-poitiers.fr (mailto:jean-claude.lecron@univ-poitiers.fr)
Publication History
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Article first published online: 14 MAR 2013
Manuscript Accepted: 20 DEC 2012
Manuscript Revised: 9 OCT 2012
Manuscript Received: 3 MAY 2012
Abstract
Article (/doi/10.1002/term.1690/full)
References (/doi/10.1002/term.1690/references)
Cited By (/doi/10.1002/term.1690/citedby)
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Keywords:
keratinocytes; foreskin; burns; graft; proliferation; differentiation
Abstract
Severe burns in children are conventionally treated with split-thickness skin autografts or epidermal sheets.
However, neither early complete healing nor quality of epithelialization is satisfactory. An alternative approach is
to graft isolated keratinocytes. We evaluated paediatric foreskin and auricular skin as donor sources, autologous
keratinocyte transplantation, and compared the graft efficiency to the in vitro capacities of isolated keratinocytes to
divide and reconstitute epidermal tissue. Keratinocytes were isolated from surgical samples by enzymatic
digestion. Living cell recovery, in vitro proliferation and epidermal reconstruction capacities were evaluated.
Differentiation status was analysed, using qRT–PCR and immunolabelling. Eleven children were grafted with
foreskin-derived (boys) or auricular (girls) keratinocyte suspensions dripped onto deep severe burns. The aesthetic
and functional quality of epithelialization was monitored in a standardized way. Foreskin keratinocyte graft in
male children provides for the re-epithelialization of partial deep severe burns and accelerates wound healing, thus
allowing successful wound closure, and improves the quality of scars. In accordance, in vitro studies have revealed
a high yield of living keratinocyte recovery from foreskin and their potential in terms of regeneration and
differentiation. We report a successful method for grafting paediatric males presenting large severe burns through
direct spreading of autologous foreskin keratinocytes. This alternative method is easy to implement, improves the
quality of skin and minimizes associated donor site morbidity. In vitro studies have highlighted the potential of
foreskin tissue for graft applications and could help in tissue selection with the prospect of grafting burns for girls.
Copyright © 2013 John Wiley & Sons, Ltd.
http://onlinelibrary.wiley.com/doi/10.1002/term.1690/abstract;jsessionid=ACFED062B1A58E9AEB0...
17/02/2014