Dr. John Still, renowned burn surgeon at Columbia- Augusta Medical Center, is presenting a study on a new type of artificial skin developed by the Ortec Corporation. CHRISTINE DE LESSIO/STAFF

Fake skin: 'This stuff works'

Artificial skin gives severe burn victims a new lease on life

Web posted November 12, 1998

By Tom Corwin
Staff Writer

It is a future unimaginable 20 years ago, pulling a box from a shelf and covering a severely burned patient with artificial skin and thus eliminating the need to take skin from elsewhere on the body.

That future is now, said burn surgeon Joseph Still of Columbia-Augusta Medical Center's Burn Unit. Dr. Still has just completed one testing phase of a new artificial skin called Composite Cultured Skin, made by Ortec Corp. Unlike past artificial skins, it's designed to be permanent, Dr. Still said.

``This stuff works,'' Dr. Still said simply. ``A lot of physicians questioned whether this would work or it wouldn't work because you're transferring permanent tissue from one individual to another individual and by all the laws of the past we've gone on, it shouldn't work. But it does work.''

In this case, the tissue being transferred is taken from foreskin discarded after circumcision. The tissue is chemically processed to remove the newborns' keratinocytes, or growing skins cells, and fibroblasts, which secrete growth factors that stimulate cell growth. These cells are imbedded in cow collagen and cultured to create two levels of skin covered by a gel. The artificial skin has been used on deep second-degree burns, known as ``partial thickness'' burns.

After it is placed on the wound, the collagen sponge in the artificial skin allows the transferred newborn skin cells to migrate through, Dr. Still said. The fibroblasts secrete a growth factor that attracts the host's capillaries, or tiny blood vessels.

``That can feed the cells, and that provides nourishment for the cells, allows them to divide and produce more cells, and therefore you have a take,'' or a meshing of the new tissue with the host, Dr. Still said.

And unlike other organ transplants -- the skin is an organ -- the circumcised tissue from the newborn has not yet acquired antigens that the host cells might reject, Dr. Still said.

``It's a universal donor, so that anybody who gets burned and comes in the hospital can get their burn grafted with this product,'' Dr. Still said. So far, he has done 13 patients. Seven are 100 percent healed, and three are a partial success, Dr. Still said. That's an incredible rate for a new product, he said.

This photo shows a burn patient 14 days after a skin graft on the left and the use of artificial CCS on the right. SPECIAL

When the artificial skin is compared to skin grafted from the patient, the Ortec skin actually looks better, Dr. Still said.

``There's less scarring, but I don't know why,'' he said. In time, the host's cells replace those of the graft, and the skin looks more like the skin around it.

The next step will be to use the artificial skin to close the wounds of donor sites when skin is taken to graft a burned area, Dr. Still said. Covering just those sites is a $100 million business alone, and overall there is a $2 billion market for treating severe burns, said Ron Lipstein, chief financial officer for Ortec.

By eight weeks, the artificial skin is beginning to take on some of the patient's own pigment as it meshes with the host's natural skin. SPECIAL

More important, having the artificial skin available and not having to use the patient's own skin can cut time in the hospital by a week, Mr. Lipstein said.

For Dr. Still, it is a remarkable step in a 20-year journey of treating severely burned patients. Patients with a 30 percent burn once had only a 50-50 chance of surviving, Dr. Still said.

``If you got both of your legs burned, you were dead,'' Dr. Still said.

Now, he can foresee a time when he can treat and possibly save a patient with nothing left.

``Not only can you get somebody with 100 percent burn covered, but you can also take a child that has a burn on her leg and you can graft it with the CCS and not produce another scar from a donor site,'' Dr. Still said. ``That's how far it can go.''