Spray-on skin cells and graft mend severe wound in man with EDS
Technology provides effective option for disorder's healing challenges: Report
A promising surgical technique involving a skin transplant followed by an application of “spray-on skin cells” may help wounds to heal in people with Ehlers-Danlos syndrome (EDS), according to a recent case report.
The report is the first to document the use of this regenerative cell technology, typically used for burn victims, to successfully close a severe, chronic wound in a man with classical EDS (cEDS), a genetic condition that severely impairs the body’s natural healing process. The technology provides surgeons with a novel and effective method for tackling the serious healing challenges posed by the fragile connective tissues in people with EDS, according to researchers.
“The methods used in this case aim to guide surgeons on approaching wounds in patients with EDS, including the use of various classic and new skin grafting techniques,” researchers wrote. “This case provided a novel surgical option … and offers another modality to care for patients with EDS.”
The report, “Complex Wound Reconstruction in a Patient With Ehlers-Danlos Syndrome,” was published in Plastic and Reconstructive Surgery – Global Open.
EDS: A challenge for wound healing
EDS encompasses a group of genetic disorders that affect the structure and function of connective tissue, which gives structural support to skin, joints, blood vessels, and other tissues.
cEDS is a form of the disease usually caused by COL5A1 or COL5A2 gene mutations. It is associated with symptoms such as flexible joints and elastic, fragile skin.
Because the skin is so fragile, even minor bumps and injuries can cause it to tear, leading to open wounds. Problems with the connective tissue also impair the normal wound healing process. Various medical interventions may be needed to close the injury and prevent complications from chronic open wounds, such as infections.
However, information on successful wound closure in people with cEDS is lacking.
The case report described the successful surgical treatment of a wound in a 53-year-old man with cEDS. He had previously undergone surgery to repair an injury to his patellar tendon, which attaches the kneecap to the shinbone, after he fell.
He developed a severe infection after surgery that was causing tissue death. To control that infection, his doctors performed a series of procedures to remove damaged tissue down to the bone. The cleaned wound area was covered with a piece of muscle and an artificial skin substitute to protect it and promote healing.
His medical team also gave him a few other standard treatments to promote wound closure, but the underlying cEDS was complicating the process. He was referred to the hospital’s burn team, which decided to treat the area with a split-thickness skin graft (STSG) followed by Recell.
STSG is a surgical procedure in which a layer of skin is removed from one part of the body and transplanted to the wounded area.
Avita’s Recell system is a technology platform that uses a person’s own skin sample to grow a suspension of spray-on skin cells. This suspension contains live skin cells that stimulate the body’s healing processes and promote skin regeneration.
Following STSG, the spray-on cells were applied to the wound area and the donor site to facilitate healing.
After one week, the transplanted skin had taken hold without signs of infection, and the wound ultimately healed completely. A little over a year later, the man had regained most normal functions, including walking, climbing stairs, and exercising.
“This case indicates the potential benefits of the split-thickness skin graft and Recell method for patients with EDS, offering an effective treatment modality for significant wound healing challenges in this population,” the researchers wrote, adding that this was the first study to report the use of Recell in people with EDS.
The scientists noted that Recell’s adoption may be limited by cost, device availability, and the need for clinical expertise to employ it. Still, “its biological benefits merit further study, particularly for patients with compromised healing.”
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