After severe burn injury, the full-thickness burn areas are excised (in the first week) and then temporarily covered with allograft (cryogenic preserved cadaver skin). This first covering is then replaced with thin skin meshed autograft. In this study, either the dermal substrates cellularised LG002 or uncellularised LG002 will be grafted, after excision, in symmetrical areas, in replacement of the allografts. Fourteen to twenty one days after this first covering, the dermal substrate will be covered with thin skin meshed autograft.
For lesions that cannot heal spontaneously, the wound is excised until fascia. Four contiguous dermal substrates (uncellularised and cellularised) are randomly grafted on each symmetric area. A primary siliconized dressing will cover the wound. Secondary dressing: dressing gauze impregnated with physiologic serum and/or sterile dried dressing gauze, the whole is maintained by a (slightly compressive) tubular or elastic bandage. Thin skin meshed autograft will occur 14 to 21 days after dermal substrate cellularised LG002 or uncellularised LG002 grafting (time frame necessary for the site to vascularize). Meshed autograft development must be identical in both symmetric areas, for one single patient.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
20
application depending on burn injury surface
depending on burn injury surface
Hôpital d' Instruction des Armées de Percy, Service des Brûlés
Clamart, France
Hôpital Cochin, Service des Brûlés
Paris, France
Percentage of take of thin skin autografts 6 days after their application on dermal substrate cellularised LG002 or uncellularised LG002 (visual assessment + photography)
Time frame: 6 days after their application on dermal substrate cellularised LG002 or uncellularised LG002
Short and medium term: Percentage of take of thin skin autografts 12 and 30 days after their application
Time frame: 12 and 30 days after their application
Long term: Clinical evaluation (Vancouver scale 1, 3, 6, 12 months) and histological evaluation (3mm biopsy) to investigate the dermal-epidermal junction and the extra-cellular matrix (1 and 6 month) in order to evaluate the scar quality
Time frame: 1, 3, 6, 12 months
Tolerance parameter: Investigator's global judgement, post grafting infection (swabbing during each new dressing for staphylococcus aureus detection), adverse event for intolerance
Time frame: each application
Supplementary parameter: Allogenic fibroblasts survival : chimerism study with biopsy (1 and 6 months)
Time frame: 1 and 6 months
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