Autologous dermal fibroblasts may be useful in the treatment of diabetic skin
wounds. We hypothesized that cultured fibroblasts or cultured keratinocytes would not only survive in a hyperglycemic
wound environment but also enhance the rate of re-epithelialization. We previously developed a new porcine model of delayed cutaneous wound healing in the diabetic pig. Full thickness
wounds were created on the dorsum and dressed with
polyurethane chambers to keep the
wounds wet and to allow for
wound fluid monitoring.
Suspensions of either autologous fibroblasts or autologous keratinocytes were injected into full thickness
wounds and compared with
wounds treated in a wet environment in
normal saline. Serum
glucose and
wound fluid
glucose concentrations were monitored daily.
Wound contraction was monitored and biopsies taken on day 12.
Transplantation of
suspensions of autologous fibroblasts or autologous keratinocytes enhanced re-epithelialization of cutaneous full thickness
wounds.
Wounds treated with autologous fibroblasts showed a re-epithelialization rate of 86.75% and
wounds treated with autologous keratinocytes showed a re-epithelialization rate of 91.3%. This is compared with a re-epithelialization rate of 56.8% seen in the
normal saline treated
wounds. While previous studies have shown fibroblasts
suspension to have little effect in the treatment of full thickness
wounds in nondiabetic
wounds, this study shows a clear beneficial effect in the use of fibroblast or keratinocyte
suspensions for the cutaneous healing of diabetic
wounds in pigs.