Table 3 Clinical use of human cultured dermal substitutes (CDSs).

From: Cellular human tissue-engineered skin substitutes investigated for deep and difficult to heal injuries

Reference

Cells

Type of clinical study

n (male / female)

Age (years)a

Treatment-related adverse events

Indication

Total body surface area (TBSA) affected (%)a

Affected area covered (%)a or affected area covered (%TBSA)a

TESS successful engraftment (%)a or TESS successful engraftment (% TBSA)a

Period between skin biopsy and grafting (days)a

Follow-up (months)a

Outcomes

60

Allogeneic fibroblasts

Case Report

5 (4/1)

59.5 ± 19.5 (39–81)

In one patient, infection after 14 days was observed but resolved

Burns

100

87.8 ± 9.6 (75–98)

0 (TESSs were cryopreserved previously)

10–14

Failed to take permanently on the wound surface, but was able to produce cell growth factors which improved wound healing

1 (0/1)

88

None

Necrotizing fasciitis

100

88

61

Allogeneic fibroblasts

Case Report

3 (2/1)

58.6 ± 12.3

None

Skin ulcers prior to autologous skin grafting

100

26.8

0 (TESSs were cryopreserved previously)

6

A greater amount of healthy granulation tissue was produced and suitable for autologous skin grafting

62

Allogeneic fibroblasts

Case Report

13 (3/10)

65 ± 9.5 (48–79)

One case presented local infection

Chronic and consecutive leg ulcers

100

81.3 ± 9.65 (61–96)

0 (TESSs were cryopreserved previously)

2 ± 1.2 (0.75–4.75)

Effective not only for producing tissue granulation and epithelialization, but also for removing necrotic tissue

63

Allogeneic cryopreserved or fresh fibroblasts

Case Report

7 (5/2)

40.4 ± 16.6

None

Surgical wounds

100

100

0 (for TESSs previously cryopreserved)

7 (considering only time of culture of the fresh TESSs)

0.27

Cryopreserved TESSs were capable of releasing sufficient amounts of several cytokines and of promoting re-epithelialization to a degree comparable to fresh TESSs

64

Allogeneic fibroblasts

Case Report

5 (0/5)

62.6 ± 24.1 (37–89)

None

Skin ulcers

100

66.7

0 (TESSs were cryopreserved previously)

2

Capable of promoting wound healing in intractable skin ulcers that failed to improve despite daily treatment with bFGF for more than 2 months

65

Allogeneic fibroblasts

Case Report

8 (3/5)

53.6 ± 14.1 (33–70)

One case presented local infection

Intractable skin ulcers

100

78.4 ± 20.5 (36–100)

0 (TESSs were cryopreserved previously)

1 ± 0.3

Healthy granulation tissue and epithelization developed rapidly in many cases

66

Autologous fibroblasts

Randomized, Controlled, Multicenter Clinical Trial

31 (21/10)

61.2 ± 11.4

None

Diabetic ulcers

100

84

21–28

12

Time required for complete healing were lower in the TESS group than control group

67

Autologous fibroblasts

Prospective, Open‐Labeled Clinical Trial

5 (5/0)

60.6 ± 11.1 (47–73)

30 adverse events, two directly related to the treatment but resolved

Diabetic ulcers

100

94 ± 8.9

>10

3

Side effects were not serious, and three patients were completely healed within 12 weeks after application

55

Allogeneic fibroblasts

Retrospective Observational Study

17 (11/6)

63.3 ± 14.2 (42–91)

None

Chronic skin ulcers

100

73.0

3.2 ± 2.3 (0.6–7)

There was an overall reduction of 73% in comparison with the initial wound size

68

Allogeneic fetal fibroblasts

Randomized, Double-Blind, Phase I Clinical Trial

10 (9/1)

29.5 ± 11 (13–46)

None

Surgical wounds

100

94

7 (considering only time of culture of the TESSs)

0.5

Re-epithelialization was faster than in control groups

  1. aExpression of measures: mean ± standard deviation (range).