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Doctors Engineer 'skin' From Fetal Cells To Treat

Tia

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In a procedure that could revolutionize burn treatment, doctors have used fetal skin cells to successfully heal young children with severe scalding injuries, avoiding the need to remove a patch of their own skin for a graft.

The skin cells, taken from an aborted fetus and grown in the lab into a sheet-like covering, acted as a "biological Band-Aid," said lead researcher Dr. Patrick Hohlfeld, a professor of gynecology and obstetrics at the University Hospital of Lausanne in Switzerland.

Hohlfeld said the researchers thought the fetal-cell sheets would act like a traditional graft, knitting together with the edges of the wound and being incorporated as part of the patient's skin surface.

But they were surprised to find that the fetal-cell patch didn't form a bond with the skin, and either dissolved or turned into a gel-like film that was easily removed.

"We observed spontaneous healing of the wound, which you would never observe in normal conditions (with a traditional graft)," he said from Lausanne. "It wouldn't heal that way, it wouldn't heal that quickly, it would takes months and it wouldn't cover the whole surface."

The doctors used the bioengineered skin on eight children aged 14 months to nine years old, who had deep second-and third-degree burns to their hands, feet, legs or buttocks. The wounds were caused by contact with such items as boiling water, fire and an iron.

Over an average of three weeks, the children's lesions were redressed every three to four days. Each time, a new fetal skin patch was placed over the burn and rebandaged.

The burns healed over in an average of two weeks; with traditional skin grafting, healing can take up to three months and require more than one operation, the researchers report in Thursday's online edition of the Lancet.

Redressing the burns - an often excruciating process with traditional grafting - was much easier for kids to endure, Hohlfeld said.

"Not only did they heal, but it had a very good impact on the pain they were experiencing - you need several dressing changes and usually you have to put them to sleep to do that - and with this technique most of them didn't need it.

"So you avoid a lot of things. You . . . avoid further taking another piece of skin on another part of the body and creating another scar."

Rejection by the body's immune system also wasn't a problem because the fetal skin patch didn't become connected with the patient's own tissue, but just lay on top, he said.

The Swiss researchers knew that fetuses heal scarlessly when small surgical procedures are performed on them in the womb, so they decided to see whether that would hold true if fetal skin were transplanted onto patients' wounds.

A woman gave them permission to biopsy four square centimetres of skin from her 14-week-old fetus that had been aborted for "medical-social" reasons. The doctors then divided and multiplied the cells, which were seeded into a collagen "construct," producing nine-by-12-centimetre sheets of bioengineered skin.

The procedure is bound to raise ethical flags because the skin was obtained from an aborted fetus, a source that raises the spectre of women agreeing to truncated pregnancies to provide new body parts for the old or ailing.

Hohlfeld said such a scenario would never happen because it wouldn't be necessary.

"It wouldn't be a question since we can prepare millions of constructs out of one skin biopsy," he said. "I understand the concern, but . . . there are pregnancy terminations every day. Nobody would start a pregnancy for that. There's absolutely no reason."

link..... http://www.nlm.nih.gov/medlineplus/news/fullstory_26395.html
 
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