First time compassionate use of laboratory engineered autologous Zurich skin in a massively burned child
Naiem Moiemen,
Clemens Schiestl,
Fabienne Hartmann-Fritsch,
Kathrin Neuhaus,
Ernst Reichmann,
Arina Löw,
Chantal Stenger,
Sophie Böttcher-Haberzeth,
Martin Meuli
Affiliations
Naiem Moiemen
Birmingham Children Hospital Foundation Trust, University Hospitals Birmingham Foundation Trust, Centre for Conflict Wound Research, Steelhouse Lane, Birmingham B4 6NH, United Kingdom
Clemens Schiestl
Department of Pediatric Surgery, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Pediatric Burn Center, Children’s Skin Center, Department of Pediatric Surgery, University Children’s Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Children's Research Center (CRC), University Children’s Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
Fabienne Hartmann-Fritsch
Wyss Zurich Regenerative Medicine Technologies Platform, ETH Zurich and University of Zurich, Weinbergstrasse 35, 8092 Zurich, Switzerland
Kathrin Neuhaus
Department of Pediatric Surgery, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Pediatric Burn Center, Children’s Skin Center, Department of Pediatric Surgery, University Children’s Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Children's Research Center (CRC), University Children’s Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
Ernst Reichmann
Department of Pediatric Surgery, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Children's Research Center (CRC), University Children’s Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Tissue Biology Research Unit, Department of Pediatric Surgery, University Children's Hospital Zurich, Wagistrasse 12, 8952 Schlieren, Switzerland
Arina Löw
Wyss Zurich Regenerative Medicine Technologies Platform, ETH Zurich and University of Zurich, Weinbergstrasse 35, 8092 Zurich, Switzerland
Chantal Stenger
Wyss Zurich Regenerative Medicine Technologies Platform, ETH Zurich and University of Zurich, Weinbergstrasse 35, 8092 Zurich, Switzerland
Sophie Böttcher-Haberzeth
Department of Pediatric Surgery, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Pediatric Burn Center, Children’s Skin Center, Department of Pediatric Surgery, University Children’s Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Children's Research Center (CRC), University Children’s Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Corresponding author at: Department of Pediatric Surgery, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
Martin Meuli
Department of Pediatric Surgery, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Pediatric Burn Center, Children’s Skin Center, Department of Pediatric Surgery, University Children’s Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Children's Research Center (CRC), University Children’s Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
Managing major pediatric burns remains a challenge for the entire multidisciplinary team. Limited donor sites make complete early wound closure impossible and the need for temporary cover options and ideally autologous cultured skin increases. We report the case of a 5 year-old child with a 95% total body surface area (TBSA) deep flame burn and the large scale application of a laboratory grown, autologous dermo-epidermal skin analogue, termed Zurich Skin, justified and permitted as compassionate use. In total, 1626 cm2 of Zurich Skin were transplanted onto the patient, relating to approximately 20% of its TBSA. Zurich Skin was easy to handle and apply, showed excellent engraftment rates of 80–90% over dermal substitutes as well as over allodermal remnants, and after a maturation process lead to a soft and solid, close to natural skin coverage. Unfortunately, the child died after a prolonged and intense struggle due to multiple organ failure. This case delivers the clinical proof of principle that Zurich Skin has the potential to help substantially in acute cases with massive skin loss.
