Dr Shiva Akbarzadeh is a skin biologist at the Alfred and Monash University, working on regrowing skin (or tissue engineering) for burn wound treatment. See http://www.med.monash.edu.au/surgery/alfred/research/skin-tissue-lab.html See also https://www.thinkable.org/competition/15 so you can vote for Shiva's video entry. What she says: The Alfred has the only specialised adult burns unit in Victoria and treats around 400 patients per year. The gold standard for treating deep burns is skin grafts. That is difficult when a patient has massive burns and not enough donor sites. Shiva is researching growing artificial skin in the laboratory using patients’ own cells that can be applied instead of skin grafts. 0:31 Skin comes in three layers. The epidermis provides a physical barrier. The layer beneath, the dermis contains various skin appendages, blood vessels and sensory nerves. Underneath these layers is the subcutaneous tissue that attaches the skin to the underlying bone and muscle (1, 2). If the epidermis and dermis are destroyed, as happens in extensive burns, the patient may not have enough donor skin for grafting. 1:01 Tissue engineering has revolutionised burns treatment. There are now commercial dermal substitutes that can be used to replace dermis. But the epidermal layer would only graft if it is the patient’s own (3). 1:14 Our laboratory has established a technique to grow patients’ epidermis from a small biopsy in the incubator (4, 5). But this technique although powerful is limited. It only replaces the epidermis. So in deep burns, the dermis has to be replaced first, allowing it to vascularise and heal and then the artificial epidermis can be grafted. The process takes time; it requires multiple procedures and has a risk of infection. We have developed techniques to create composite skin in the laboratory that has close to native skin morphology (6). Our goal is enabling surgeons to replace both dermal and epidermal layers of damaged skin with tissue engineered skin in a single procedure. We would speed up the wound healing and reduce the risk of infection. 2:07 We isolate and expand dermal and epidermal cells from patients. Dermal cells are seeded into a matrix. Matrix surface is capped with clotted plasma and epidermal cells are then grown on the top. Both layers continue to grow in atmospheric air for skin maturation. Our next step is to test it in animals for graftability and then scale up the production for patient treatment. 2:35 Great science comes about with great collaborations. We are collaborating with material engineers at Monash to develop novel dermal matrices which are made from natural dermal components and would enhance epidermisation both in laboratory incubators and on patients. All of this would not be possible without securing funding and you can make a difference. References: 1. Rochat, A., Grasset, N., Gorostidi, F., Lathion, S. & Barrandon, Y. Regeneration of Epidermis from Adult Human Keratinocyte Stem Cells. Hand Book of Stem Cells 767-780, doi:10.1016/b978-0-12-385942-6.00065-2 (2013). 2. Hansen, J. T. N. F. H. Netter's clinical anatomy. (Saunders/Elsevier, 2010). 3. Shahrokhi, S., A. Arno, and M.G. Jeschke, The use of dermal substitutes in burn surgery: acute phase. Wound Repair Regen, 2014. 22(1): p. 14-22. 4. O’Connor NE, Mulliken JB, Banks-Schlegel S, Kehinde O, Green H. 1981. Grafting of burns with cultured epithelium prepared from autologous epidermal cells. Lancet 1:75-78. 5. Pellegrini G, Ranno R, Giorgio S, Bondanza S, Guerra L, Zambruno G, Micalli G, De Luca M. 1999. The control of epidermal stem cells (holoclones) in the treatment of massive full-thickness burns with autologous keratinocytes cultured on fibrin. Transplantation. 68:868-879. 6. Paul, M., Kaur, P., Herson, M., Cheshire, P. Cleland, H., Akbarzadeh, S. Use of clotted human plasma and aprotinin in skin tissue engineering - A novel approach to engineering composite skin on a porous scaffold. J. Tissue Engineering- Part C 2015

• published: 13 Jul 2015
• views: 754