Immunohistochemical studies on regeneration in cultured epidermal autografts used to treat full-thickness burn wounds

The normal pattern of healing following culture grafting is not well-established. The present study describes the immunohistochemical expression of differentiation markers during various stages of wound healing after resurfacing full-thickness burn wounds with cultured epidermal autografts. For this purpose, biopsy specimens were obtained from six patients 6 days to 4.5 years after transplantation. A panel of monoclonal antibodies was used against various differentiation-specific protein markers, including cytokeratins, involucrin, transglutaminase and filaggrin. Findings from early and late biopsies were compared with site-matched normal skin and cultured epidermal sheets. The persistence of cytokeratins 6 and 16, and to a lesser extent, the abnormal distribution of involucrin up to 4.5 years after resurfacing burns with cultured autografts was observed. These findings confirm previous studies--that the newly formed epidermis after culture grafting remains in a hyperproliferative state for a long time, which may be caused by the absence of a modulating dermal factor. Our results suggest that keratinocyte maturation following culture autografting does not return to normal for at least 4.5 years after healing of full-thickness burn wounds.