The Miracle of Tissue Engineering

FOR IMMEDIATE RELEASE

CONTACT:
Missy Gough
(847) 330-0101, ext. 384
E-mail: [email protected]

Karen Klickmann
(847) 330-0101, ext. 341
E-mail: [email protected]

THE MIRACLE OF TISSUE ENGINEERING

SCHAUMBURG, IL (February 10, 1999) - As a result of a rare bone disease, venous ulcers were a common occurrence for Patricia Windish, age 44, of Davenport, Florida. To repair these difficult-to-heal, painful open sores on Windish's ankle, skin would be grafted from one part of her body onto her open wound almost every three years. When her venous ulcer reopened a year after her latest surgery, Windish's physician recommended amputation. "I was devastated," said Windish. I begged my doctor to do one more skin graft, but he refused."

Windish immediately began to search for a second opinion. While many doctors agreed that her leg should be amputated, Anna Falabella, M.D., an assistant professor of dermatology at the University of Miami, had another opinion. Dr. Falabella recommended performing a skin graft using tissue-engineered skin which had been approved for venous leg ulcers earlier in the year. "After a lifetime of medical disappointments, I was very skeptical that it would work," Windish said. "But it was a miracle. The procedure was very successful - not only was my leg not amputated, but the pain has subsided and I have been able to resume my teaching career."

Recent developments in the field of tissue engineering, such as its approval for venous leg ulcers like Windishs', are improving the body's ability to heal its serious wounds, as well as improving patients' quality of life.

"Skin grafts are a common treatment for patients with burns and ulcers," stated William Eaglstein, M.D., Professor and Chairman, Department of Dermatology, University of Miami, and author, along with Vincent Falanga, M.D., of "Tissue Engineering For Skin: An Update" published in the December 1998 issue of the Journal of the American Academy of Dermatology. "If a patient's skin is damaged or he or she does not have enough extra skin, a skin autograft is not a viable option. Tissue-engineered skin alleviates this problem as the skin comes off the shelf instead of off the person. Off-the-shelf skin also avoids creating a painful wound elsewhere and frequently avoids the cost of operating room time needed to harvest the autograft."

"Tissue-engineered skin holds great promise for the field of dermatology," continued Dr. Eaglstein. "In addition to chronic wounds and skin diseases, future uses of tissue-engineered skin could include tattoo removal and the rejuvenation of aging skin." Some tissue-engineered skin products, such as the skin used on Windish, contain living cells from human neonatal foreskin. After obtaining parental permission and testing the mother for infectious diseases, cells are extracted from newborn foreskin following a circumcision. Because these living cells reproduce, the tissue from one newborn circumcision can generate 250,000 tissue-engineered skin products.

Tissue-engineered skin can heal a patient's wound in two ways. First, it may function as a skin replacement which is integrated into the skin of the patient. However, tissue-engineered skin is generally thought to be replaced by the patient's own tissue and does not appear to be a permanent skin replacement. Second, the tissue-engineered skin products that contain living cells are thought of as "smart tissues." It is believed that the cells of these tissue-engineered skins can sense the environment into which they are placed and take "corrective actions" by producing chemical signals which stimulate the patient's own skin to repair itself.

To apply tissue-engineered skin, the wound is cleaned and dead tissue is removed. The tissue-engineered skin is applied to the wound like a dressing which is held in place by bandages, staples, or stitches. One to two days of bed rest is ideal for the patient after the procedure, but it is not required. As long as the patient is careful and does not apply pressure to the wound, a formal recovery period is not necessary. The dermatologist removes the patient's bandages a week after the procedure and then checks the progress of the wound's healing weekly for about a month. If needed, another graft can be done six weeks later or sooner. The tissue-engineered skin products currently available and those under study do not cause rejection reactions that are clinically detectable. While foreign tissues have traditionally induced acute rejection, tissue-engineered skin utilizing living cells appears to have overcome this reaction. Although the human cells and animal matrix materials used in tissue-engineered skin products are tested to avoid transmission of viruses such as hepatitis and HIV, the possibility of long-term toxicities cannot be totally excluded.

Current statistics are not available as to the number of patients receiving tissue-engineered skin each year, but doctors are becoming more familiar with the procedure and are increasing its use in their practice. As with any new procedure, patients should consult their insurance carrier to determine if tissue-engineered skin is covered by their policy. The American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership over 11,000 dermatologists worldwide, the Academy is committed to: advancing the science and art of medicine and surgery related to the skin; advocating high standards in clinical practice, education, and research in dermatology; supporting and enhancing patient care; and promoting a lifetime of healthier skin, hair, and nails. For further information, contact the AAD at 1-888-462-DERM or www.aad.org.

###