Clinical evaluation of allogeneic cultured dermal substitutes for intractable skin ulcers after tumor resection

Clinical research on allogeneic cultured dermal substitute (CDS), which was newly developed at the R&D Center for Artificial Skin of Kitasato University, has been carried out in medical centers across Japan with the support of the Millennium Project of the Ministry of Health, Labor and Welfare of Japan. Allogeneic CDS was prepared by cultivation of fibroblasts on a two-layered spongy matrix of hyaluronic acid and atelo-collagen. This paper reports the clinical results of application of allogeneic CDS in 12 patients with full-thickness skin defects after surgical resection of skin tumors. In 9 of 10 patients, healthy granulation tissue developed immediately, allowing us to perform split-thickness skin grafts at an early stage. In two cases, allogeneic CDS was used to cover an expanded mesh skin graft that had been applied to treat a large ulcer, and rapid epithelization was observed. No patient developed local infection nor local tumor recurrence after treatment with CDS. The spongy matrix itself as well as the vascular endothelial growth factor (VEGF) released by the allogeneic CDS seemed to be beneficial for the treatment of intractable skin ulcers. Allogeneic CDS functions as an excellent biological dressing, and could dramatically change the treatment of intractable skin ulcers.