Research has shown that scar formation is
significantly reduced if the wound heals quickly. A burn wound that
takes 21 days or more to heal has a greater than 70% risk of developing a
significant scar, compared to a burn wound that heals in less than 10
days, which has only a 4% risk of developing a hypertrophic scar. Hence
it is imperative to treat burns as soon as possible in order to reduce
scarring and improve the patient's ability to move and function in
society.
The development of skin cell
transplant technology began in 1990, when Dr Wood was treating patients
for serious burn injuries. Treating large burn injuries traditionally
involves applying cultured skin in the form of sheets to the wound. The
skin sheets are grown from skin cells obtained from the patient but
usually take 14-21 days to produce. Dr Wood discovered that scarring
could decrease if the wound could be treated within 10 days. She found
that although skin sheets produced in 10 days often had holes in them,
these areas healed faster than those treated with confluent sheets, and
with less obvious scarring, because the cells had not achieved total
confluence. And thus, a new technique was born.
The
next step was to apply pre-confluent cells in a suspension even as
early as five days before they formed a sheet, with the 'spray on'
technique optimal. In this technique cells are harvested from the
epidermis of a patient, and expanded in culture. They can be grown into a
concentrated single cell suspension or a confluent cell sheet for
application to the patient's wound. The healthy, living cells are
cultured in a highly specialised laboratory by natural division
processes, and then transplanted into the patient. As the original cells
are taken from the actual patient instead of a donor (autologous cell
culture), the body accepts these cells as its own, the tissue continues
growing, and the healing process is optimised. The burn acts as an ideal
culture medium, and sprayed on pre-confluent cells grow more quickly on
the patient than in the laboratory. The advantage is that wounds or
burns heal rapidly and leave less scarring if a skin graft is applied
soon after an injury.
The CellSpray is
another innovation that improves treatment for larger wounds. Also known
as 'Spray on Skin,' the process involves using an aerosol delivery
system to apply cultured skin cell suspensions evenly to larger and more
massive wounds or burns.
Commercialisation
of these techniques and technology is handled by the Australian
commercial biotechnology company, Clinical Cell Culture or 'C3.' The C3
laboratory now cultures small biopsies into bigger volumes of skin cell
suspensions in as few as five days, and this service is used by surgeons
in Sydney, Auckland and Birmingham, UK. Cells can be delivered via
aircraft and ready for use the next day in many cases. Royalties from
licensing will be ploughed back into a research fund, called the McComb
Foundation.
The intellectual property is
protected by a combination of trade secrets and trademark processes,
where employee confidentiality is paramount, and knowledge about C3's
culturing processes is limited. The company has now reached an exciting
stage with new products being rolled out and training of medical staff
in other hospitals being undertaken. Recently, training has been
completed for the Royal Hobart and Royal Brisbane Hospitals. ReCell is
the latest innovation developed by C3, and having received WA Government
funding support, will hopefully be on the market by the end of next
year. It will come in a kit that will enable surgeons to harvest skin
cells in theatre to allow them to treat small wounds in one operation.
Cells are harvested from a small biopsy on a petri plate within 30
minutes. ReCell also allows pigment cells to be harvested, so it can be
used in the treatment of small areas of pigment loss, like the size of
two hands or a face.
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