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Last Updated: Monday, 5 September 2005, 23:29 GMT 00:29 UK
Spray-on cells treat severe burns
John Barratt
John Barratt suffered huge burns
Doctors are to assess the effectiveness of using a spray-on skin cell culture to treat burns victims.

A team at Queen Victoria Hospital in East Grinstead, West Sussex, has used the technique to treat several patients - including a man with 90% burns.

But they now hope to produce hard evidence of its worth to justify its high cost.

The latest study will examine whether the cells go on to become a fully functioning part of the skin.

The technique was first pioneered in Perth, Western Australia, and used on some patients - including victims of the Bali bombing - but has never been fully evaluated.

It can cover a much bigger areas and do it much more quickly
Mr Phil Gilbert

The East Grinstead team have embraced the technology, and used it to treat several patients with severe and extensive burns.

The current method of treating burns victims is to take samples of skin from unaffected areas, and put them through a meshing machine.

This expands the tissue, creating a string vest pattern of connected patches of skin surrounded by large holes.

Slow method

The technique can be used to cover big patches of tissue where the skin has been completely burned away.

However, it is slow, and not always effective.

The East Grinstead team believe the new technique has the potential to be much more useful.

Elderly patient's legs before and after treatment
The treatment helped heal severe burns on an elderly patient's legs

Mr Phil Gilbert, a consultant plastic surgeon who specialises in burns, told the BBC News website: "It can cover a much bigger areas and do it much more quickly.

"In pilot studies we also get the impression that wounds heal noticeably quicker with less scarring."

A healthy skin sample is taken from the patient, and split in the laboratory to separate out the surface cells, known as keratinocytes.

These cells are then cultured for two to three weeks, and made up into a suspension.

At the same time other skin cell tissue from the patient is put through a different type of meshing machine, known as a meek mesher.

Instead of creating a string vest pattern of tissue, this machine cuts the skin sample into tiny little squares.

Tissue combination

The cultured cells are then sprayed on to the small pieces of tissue and combine to create new skin for the patient.

Mr Gilbert said the technique had been used to treat a man known as John Barratt - not his real name - who suffered 90% burns after being doused with petrol and set alight.

Initially, John's burns were shaved off, and he was covered in sterile skin which had been harvested from bodies and kept frozen in storage.

Doctors were only able to take skin samples for culture from small areas of one leg unaffected by burns.

"We would have struggled to keep him alive using the standard methods," he said.

"These have been used to treat people with very extensive burns, but these have nearly always been children."

Mr Barratt was released from hospital two years ago, and has since undertaken a parachute jump to raise funds for the hospital.

His skin is far from normal - it is thin, and has no hair follicles, sweat or oil glands.

But it has begun to settle down, and take on a more natural pale colour.

Justifying the cost

Mr Gilbert said the aim of the new study was to test whether the cultured cells continued to divide and form new skin, or whether new tissue only came from the tiny pieces of skin with which it is combined.

Strict regulations on the storage of skin, introduced in the wake of concerns over CJD, mean that it is very expensive to culture cells in this way.

"People want to know why they should spend x thousand pounds on a patient, so the stronger the evidence we can produce that is worthwhile the better," he said.

The new study will focus on 24 adults with severe burns, and 50 children under the age of three with scalds.




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