Recently, at the National Burn Institute, local experts successfully implemented fibroblast grafting techniques in the treatment of burn injuries. This achievement represents a significant milestone, showcasing an internationally recognized technique that Vietnamese scientists have developed after extensive research.
In Vietnam, there has previously been no cellular therapy for the research and treatment of wounds, despite the high demand for wound care.
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(Photo: TTO) |
Each year, the National Burn Institute treats approximately 3,000 burn patients. This figure does not account for the increasing variety of wounds arising from societal developments, such as radiation injuries, chronic wounds due to diabetes, pressure ulcers related to neurological conditions, and wounds resulting from peripheral vascular diseases.
Treatment faces significant challenges, as although there are some remedies that stimulate wound healing, they are generally limited and primarily based on traditional practices.
Dr. Đinh Văn Hân, who directly conducted this research, stated: Fibroblasts are the most crucial cells during the wound healing phase. Fibroblast grafting essentially involves producing fibroblast sheets in a laboratory and grafting them onto the wound.
Cultivating fibroblasts has been confirmed through numerous studies to effectively promote the wound healing process. Fibroblasts are present in all body tissues. In the skin, they are located in the dermis and play a key role in the proliferation phase of wound healing.
They produce matrix proteins that ensure the stability and integrity of the tissue once the wound has healed. Additionally, fibroblasts are a crucial source of various growth factors that stimulate wound healing, such as TGF-b, PDGF, and KGF.
Fibroblasts also generate components of the extracellular matrix that serve as a foundation for epithelialization, providing laminin, decorin, elastin, and fibronectin fibers for epithelial cells to adhere to and migrate over, thereby accelerating the epithelialization process that covers the wound.
Moreover, in chronic wounds that are healing, or in acute wounds that are closed in the second phase, fibroblasts transform into myofibroblasts in the granulation tissue of the open wound, facilitating contraction and quicker healing of the wound. Consequently, Vietnamese scientists have utilized fibroblast culture technology to increase the density of these cells at the wound site, thereby speeding up the healing process.
The fibroblast culture process is carried out entirely in a laboratory, similar to general cell culture. Initially, scientists take about 1.5 – 2 cm² of skin from the patient and place the skin sample into a culture medium containing specific chemicals that separate the fibroblasts from the skin.
After removing unnecessary cells that are mixed within the fibroblast population and creating a homogeneous fibroblast sample, they expand it until it reaches the required quantity and quality standards. These fibroblasts are then placed onto a scaffold.
The scaffold used must meet certain standards, such as being non-toxic to the cells, capable of adhering to the wound, preventing bacterial invasion, not causing dehydration or fluid loss in the wound, and allowing for gas exchange between the inside and outside of the wound. When the cells stabilize, meaning they can still proliferate on the scaffold and secrete substances that stimulate wound healing, they are of sufficient quality, akin to normal cells in the patient’s body, and will be grafted onto the wound surface.
In practice, compared to traditional treatment methods currently used in Vietnam, fibroblast grafting will lead to quicker wound healing and better scar quality.
Therefore, fibroblast grafting is widely indicated for burn patients. Fibroblasts can be grafted onto burn areas to stimulate epithelialization, or onto skin graft sites to promote faster healing and increase the potential for reusing healthy skin areas in extensive burn treatments.
For deep burns, fibroblast grafting is combined with mesh skin grafting to cover extensive deep burns, enhancing the adhesion of the grafted skin and accelerating the growth of epidermal cells from the graft.
