Now we can use spray-on skin to treat burns
Maddie Massy-Westropp
February 15, 2021
Your skin is a layer of protection against dangers in your environment like microorganisms, harmful chemicals and damaging UV light. Open wounds should be covered as soon as possible; when a patient has a large area of missing or damaged skin, a skin autograft is sometimes performed. This involves taking a layer of healthy skin from another part of the patient’s body and reattaching it to the wound area.
But what about when patients have extensive wounds, for example burns affecting large areas of their body? Sometimes, not enough undamaged skin is available to cover the wounds completely. In these situations, healthy skin is harvested, given time to heal and then re-harvested over several weeks to create multiple grafts. Skin can also be artificially grown in the lab from a sample of the patient’s own skin cells. During this time, the wounds are temporarily covered with synthetic skin substitutes, or skin from another person (allograft) and animals such as pigs (xenograft). This temporary ‘skin’ can be rejected by the patient’s immune system or lead to a dangerous infection.
But what if you could skip the autograft and literally spray on skin cells? The RECELL® System enables healthcare professionals to prepare a sample of the patient’s own skin cells, which can be applied to a burn area to form a new layer of skin.
Where does this technology come from?
The RECELL® System was developed in Perth in the 1990s by plastic surgeon Professor Fiona Wood and scientist Marie Stoner. Instead of growing skin artificially in the lab, which can take several weeks to produce enough material for a graft, the skin would be grown directly on the patient. After initial attempts involving lining gloves with skin cells or attaching cells to an adhesive dressing failed, one of the women said, “we should just spray this stuff on”. It was a throwaway comment at the time but formed the basis of the RECELL® System as we know it today.
How does spray-on skin work?
Using the RECELL® System, a small section of healthy skin is harvested and placed a solution containing the enzyme trypsin. The trypsin breaks down the connections between cells in the epidermal and dermal layers of the skin, allowing individual cells to be released when the tissue is scraped with a scalpel. These cells, which include keratinocytes, fibroblasts and melanocytes, can then be sprayed onto the wound. The cells proliferate and form connections to one another, forming a new layer of skin.
When the RECELL® System is used, up to 80 times less donor skin is needed compared to a conventional skin graft. This is a game changer for patients with burns covering large areas of their body.
What's next for spray-on skin
Currently the RECELL® System, which is marketed by the company Avita Medical, is used mainly in the US for the treatment of burns. The treatment is gaining traction in other countries, including Australia, and is being trialled for the treatment of non-burn related wounds and pigmentation disorders like vitiligo. Avita Medical is also exploring the use of the RECELL® System to rejuvenate ageing skin. Much is possible when we can harness our skin’s own regenerative properties.