The Development of a Tissue-Engineered Skin Composite Utilising a Biodegradable Polyurethane Scaffold in a Novel Bioreactor for the Treatment of Extensive, Full-Thickness Burns
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(Ch 2 Figure 4e video)
(Ch 8 Figure 8 video)
Date
2022
Authors
Dearman, Bronwyn
Editors
Advisors
Greenwood, John
Boyce, Steven (University of Cincinnati)
Boyce, Steven (University of Cincinnati)
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Thesis
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Abstract
The fabrication of a laboratory derived skin substitute that promotes epidermal and dermal
elements are alternatives that are becoming more widely studied in the field of tissue
engineering. Areas of particular interest include significant tissue injuries where skin
autograft paucity and donor sites are of concern. The introduction of these products has
the potential to reduce the number of surgeries, pain, and scarring for patients with large
Total Body Surface Area (TBSA) skin wounds, such as extensive, deep burns. The changes
in burn care over the last two decades has seen the percentage of survival burn increase,
requiring the need to seek alternative tissue sources. With this in mind, a two stage strategy
has been developed to assist with this challenge.
The first stage, a biodegradable temporising matrix (BTM) was developed to temporise
the wound, followed by the second stage of definitive wound coverage with a laboratory
fabricated skin composite, composite cultured skin (CCS). The CCS has been used in pilot
animal studies in small wounds (8cm x 8cm) (1, 2), but the concern with large burns is small
pieces may leave a patchwork quilt appearance. The primary aim of this thesis is to reduce
the need for skin autograft by upscaling the CCS using a bespoke bioreactor system to
enable the production of large pieces (25cm x 25cm) for the use in extensive full-thickness
burn patients.
To assess the CCS, optimisation methods investigating culture techniques to refine and
reduce the use of animal products for clinical use were employed. The development of
a novel bioreactor was concurrently designed to fabricate large pieces 25cm x 25cm and
tested in animal model which led to the first use of this polyurethane derived composite in
man, enabling a long-term follow-up of this patient. Further investigations were warranted
to overcome pore size of this polymer in later iterations of this dermal template and a hybrid
collagen/polyurethane were designed and tested with in vitro and in vivo results showing
the potential of a combinational product to overcome the inherent collagen contraction and
polyurethane pore size.
This thesis provides a translational clinical research story from bench to bedside, it shows
the clinical challenges and provides insights into the fabrication of biopolymers for the
construction of skin substitutes and their potential use in full-thickness extensive wounds.
School/Discipline
Adelaide Medical School
Dissertation Note
Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 2022
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This electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at: http://www.adelaide.edu.au/legals