If you were a nerd like me as a kid, then perhaps you took delight in knowing the answer to this fun trivia question: what’s the largest human organ? It’s the skin, of course! It’s hard to overestimate the importance of your skin. It protects you from the many dangerous pathogens and chemicals you may encounter on any given day. It helps you stay hydrated by preventing the evaporation of water. It contains the nerves that help you feel various sensations from the world around you. For animals such as some amphibians, their skin is how they breathe! Ok, you get it. Skin is very important! However, it’s not indestructible and when your skin gets damaged, you become vulnerable to infection and sickness. This is especially the case with burns, which can easily penetrate through several layers of skin. Now, a company called Avita Medical is taking wound and burn treatment to a whole new level with a new technology called ReCell. ReCell allows a doctor to take a small sample of healthy skin and cover a much larger area that has been injured. What’s really cool about this technology is that it’s a spray! That’s right, you lose a few layers of skin and doctors can now spray some back on! And from some of the before and after pictures seen below, ReCell shows promise as a breakthrough in treating skin injuries.
So, how exactly does ReCell work? Well, when a patient comes into the hospital with burns (or other topical injuries), the doctors would take a small sample of healthy skin from an undamaged part of the body and introduce them to the injured area. ReCell is packaged as a “all in one” kit with everything needed to harvest the healthy cells, culture them to expand their numbers, and then deliver them onto the wound via a hand-held spray. The cell harvest procedure is designed to grab all the various cell types important to heal burns and other injuries. These include structural cells (fibroblasts), cells involved in healing (keratinocytes) and even the cells that provide pigment (melanocytes). This approach not only promotes healing, but also insures that the patient avoids extensive and ugly scarring, which in itself can lead to body-image issues and a loss of self-confidence.
The concept behind ReCell is the brainchild of world-renowned Australian plastic surgeon Dr. Fiona Wood and has been continually undergoing development since the early 1990s. For a long time, the standard treatment for burns was skin grafting, where healthy skin from the patient is harvested and used to cover the damaged area. Another common treatment for burns and other skin defects is known as cultured epithelial autograft (CEA). In this process, healthy skin is again harvested from the patient and grown into “sheets” in the laboratory before being used to treat the injured skin. And while both of these techniques have saved countless lives, they have several limitations that the proponents of ReCell hope to address.
One of the biggest advantages of ReCell is how quickly it can help heal wounds. Research has found that the longer it takes a wound to heal, the greater the risk of scarring and other complications. While CEA treatment can take several weeks to culture enough cells to be applied to the wound, ReCell can usually be ready in less than 1 week, reducing the risk of extensive scarring from approximately 75% to about 4%. That’s a significant improvement! The idea to promote quick wound healing, however, is nothing new. Previously, we’ve discussed emerging technologies that aim to do just that, from skin printers to wound powders that promote the regeneration of damaged body parts. While ReCell follows this line of thinking, the approach it uses is different from these other technologies. One big difference is that skin printers tend to rely on donor stem cells whereas ReCell exclusively uses the patient’s own skin cells. Another difference between ReCell and ACell’s wound powder is that the wound powder only serves to promote healing via recruitment of the patient’s own cells. It does not actually apply cells to a wound as ReCell does. And on the surface, it doesn’t appear as if one approach is far superior than others, but the only way to find the best treatment is to test different ideas and see which works for which type of injury.
ReCell can also be used to treat patients without the need to put them under general anesthesia. Sure, surgery and the field of anesthesiology have come a long way since the days when you were just as likely to die from anesthesia as the reason for the surgery. But there is still a risk involved when drugs are used to render someone unconscious and it should be avoided when an alternative is available. Further, ReCell should also provide improvement over the current treatments when it comes to treating burns and wounds in children. When a child receives a graft or CEA treatment, the skin may not always grow or grow correctly as the child grows. This often means repeated surgeries until the child has finished growing. With ReCell, the skin can grow and stretch as normal, allowing the patient to avoid multiple, painful procedures.
Now that you know how ReCell works and all the promise it holds, here’s the bad news: it’s currently not FDA-approved for use in the US! The website of Avita Medical claims that FDA approval is pending, but it’s not clear why it hasn’t been approved yet. Having been used successfully on thousands of patients in Canada, the UK, France, Germany, and Australia (among many other countries) should help convince the FDA that this is a proven and worthwhile medical advancement. But if you’ve read other stories we’ve posted that demonstrate the slow and sometimes irrational decision-making at the FDA (particularly when it comes to stem cell treatments, though in all fairness, the FDA is bound by laws that Congress passes), it shouldn’t be all that surprising. Hopefully, this promising technology will be available in the US soon to give surgeons another option when treating burn victims. It will also be interesting to see how this technology develops over time. Perhaps a similar approach can be used to help heal and regenerate internal organs without the need for a donor. It’s likely that as the field of regenerative medicine continues to evolve, some very different technologies could come together to offer creative solutions to the need for fast and effective wound healing.