SGH researchers developed a new skin graft culture technique that could bring better treatment for victims of severe burns.

  • SGH team enriches grown grafts with stem cells
  • Resultant skin is thicker and healthier
  • Doctors estimate 5-10 years for clinical implementation

Each year, more than 11 million people worldwide suffer from second or third degree burns and burns that cover 40 per cent or more of their bodies. 

The standard treatment for such victims of severe burns is to use donor skin grafts to give temporary protection over the injured areas, while doctors culture the patients’ own skin cells in the lab into grafts that heal the wound and provides permanent coverage.

This technique, developed by Harvard physician Dr Howard Green in the 1970s, can be tedious – it takes up to four weeks to grow a graft of a substantial size. In addition, they are usually very delicate and easily torn.

Dr Ma Dongrui and Dr Alvin Chua from SGH, in collaboration with the Agency for Science, Technology and Research (A*STAR), has recently published a technique that could produce more robust, higher-quality grafts.

“Since Howard Green, there has been no technology for skin replacement that surpasses cultured skin grafts for permanent coverage of severe burns,” said Dr Chua, Clinical Scientist & Deputy Head of the SGH Skin Bank Unit.

The research team decided to fortify the grafts by enriching them with more stem cells, which has potent tissue repair capability. A cell marker is needed to identify and “catch” these stem cells alive. After months of screening potential cell markers at the SGH laboratory, they found that a protein usually tasked with evicting foreign chemicals from cells, called ABCG2, fitted the bill.

“With ABCG2, we can isolate live cells using cell-sorting technology,” said Dr Ma, Senior Scientific Officer and the paper’s lead author.

Tests in the lab showed that grafts created from ABCG2-positive cell culture, meaning they are rich in stem cells, formed thicker and healthier grafts.

Grafts created from cell culture that was not ABCG2-positive were thin, fragile and failed to form a healthy outer skin layer.

Another exciting find was that ABCG2 could potentially identify skin pigmentation cells, called melanocytes.

“Melanocytes are usually destroyed by deep burns and restoring them could facilitate a graft that blends better with the patient’s existing skin,” said Dr Chua.

There is great promise for clinical application of the finding, but doctors estimate it will take between five to ten years to clinical implementation. 

Dr Chua continued, “We hope further research can improve the quality while also reducing cost and speeding up production. For severe burn patients, time is of the essence.”