Stephen Milner, MD, BDS, DSc, FRCSE, FACS, Former Professor of Plastic and Reconstructive Surgery, Johns Hopkins, Chief Clinical Officer, PolarityTE, Inc. talks about SkinTE and it’s potential to help treat patients with severe burns.
Interview conducted by Ivanhoe Broadcast News in September 2017.
Tell me how the thought process went in to create this product. How did you know there was a need for this or what was the need you saw?
Dr. Milner: I always knew there was a need for a better skin product. For thirty years, people have been trying to obtain better skin care off the shelf, and quite frankly, it’s been fraught with difficulties. Although there have been advances, they haven’t really produced a perfect product yet. I think that Polarity is about as near as you could come to it.
How does it work?
Dr. Milner: The way in which it works is that a small biopsy is taken from the patient, about two square centimeters in size, and this is sent off to our laboratory where the skin itself is processed. It’s then returned to the patient and it literally grows on the patient so the patient is used as its own medium.
Until Polarity hits the market what has been the problem when it comes to burn treatment?
Dr. Milner: The conventional way of treating burns is with a skin graft. If you sustain a deep burn, there is a potential for that burn to become infected. The standard of care really is to remove that burn, excise it and replace the wound that you’ve created with a skin graft. Essentially, what that means, is you take a skin graft from another part of the body and you put that on to the recipient site. There are obvious problems associated with that which I can go in to.
Basically it’s a size, right size of skin area that you’re covering?
Dr. Milner: Yes, there are several problems with a conventional skin graft. First, it’s an operation. It’s an operation that produces a secondary wound in an area that wasn’t injured primarily. That wound has to heal; it usually takes about two weeks and is very painful. Second, the skin graft itself is really just a top layer of skin. So really what you’re talking about is keratinocytes that really are just proliferating on the wound. There are no hair follicles, no sebaceous glands, no sweat glands. There’s a tendency for that wound to contract and there also may be color differences. And then as I said before, you have a secondary wound that could be avoided by the use of the new technology.
At least if nothing else it’s going to make a smaller scar site, wound site?
Dr. Milner: Correct.
How long have you been working on this SkinTE?
Dr. Milner: Officially, since December 2016.
How have you overcome the problems with the current skin grafts?
Dr. Milner: There have been several ways in which we have tried to overcome the difficulties with conventional skin grafts. The first problem is that sometimes a patient might not have sufficient skin to actually cover that area. The first way is to use cadaver skin, which is essentially a skin graft. The problem with that, like any transplant, is that it will get rejected and therefore this procedure needs to be repeated every two weeks. The second way is to expand the skin by a process called meshing. We take the skin and we pass it through a machine that makes holes in it. Of course, there are problems associated with that as well, each hole heals by secondary intention, in other words by fibrosis and by scarring which can produce a cobblestone appearance. Obviously, the larger the area that is expanded in the skin, the bigger the scarring. This is one of the problems that we see with James; he does have this cobblestone-type of appearance along his arms. The third innovation really came about in the nineteen-eighties was the development of cultural epithelial autograft. Although this has been successful in saving many lives, it still has several deficiencies. Firstly, it’s only two to eight layers thick so the skin that forms tends to be extremely fragile and there are no hair follicles or sebaceous or sweat glands. Its use really limited to the front part of the body because it’s easily removed by friction if you put it on the patients back or the back of their legs. The nursing care of this technology is extremely fraught with problems.
Why would people use it?
Dr. Milner: I think that this product will be patient led. In much the same way as laparoscopic cholecystectomy was. They will have a choice, they can have a conventional skin graft in which a large piece of skin is taken from an uninjured part of the body and all the problems associated with that. Or they can have a small skin graft from a donor site which produces skin without the extensive scarring. More importantly, it produces a skin which is similar to the original skin, before they were burned.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
If you would like more information, please contact:
Naveen Krishnan
Naveen.Krishnan@polarityte.com
Courtney Cushnir
Customerservice@polarityte.com
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