Développement préclinique d'une méthode plus rapide de production par génie tissulaire d'un substitut cutané bilamellaire autologue
|Advisor:||Auger, François A.; Germain, Lucie; Gauvin, Robert|
|Abstract:||Introduction: The Laboratoire d’Organogenèse Expérimentale (LOEX) has developed a unique production technique of self-assembled autologous skin substitute (SASS). This method allows the generation of permanent skin equivalents that display a structure and a function similar to normal human skin. Problematic and objectives: This thesis presents the first results of SASS clinical use in the treatment of chronic complex wounds to demonstrate the clinical efficacy and safety. The need to develop a faster production method in order to improve burn patient prognosis is also outlined. Indeed, the delay before definitive skin coverage to insure proper thermoregulation and protection from the external environment is directly associated to the vital and morbid prognosis of this population of severely traumatised patients. The current eight weeks SASS production delay must be reduced in order to further improve burn patients quality of care and survival. Method: This work describes the development and refinement of a faster production method for SASS using decellularized dermal matrices (SASS-DM) that generated skin substitutes produced in only 4 weeks and a half. These faster produced skin substitutes where compared in vitro to the standard SASS in regard to the histological characteristics, cellular differentiation and the presence of a functional basement membrane. The faster produced SASS-DM were then compared in vivo to standard SASS by following the evolution of grafted mice in order to complete a preclinical trial of this innovative technique. Results: The faster production method for the autologous self-assembled bilayered skin substitutes was shown to be equivalent to the standard production method in vitro and in vivo. Conclusion: This work presents the clinical use of bilayered skin substitutes for the treatment of chronic venous ulcers, which was shown to be efficient as well as safe. Afterwards, the preclinical development of a new faster production method of autologous bilayered self-assembled skin substitutes is presented, allowing the culture of skin grafts in four weeks and a half instead of the previous 8 weeks long protocol, with equivalent quality and characteristics as the standard cultured skins. This innovation represents a major adjunct to severely burned patients treatments and could possibly change their surgical planning and their survival.|
|Document Type:||Thèse de doctorat|
|Open Access Date:||24 April 2018|
|Collection:||Thèses et mémoires|
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