# Parallel Mechanisms for Re-Epithelialization Following Skin Cell Suspension Autograft Application: Scientific Insights into Acute Wound Healing

## TL;DR

This study explores how skin cell suspension autografts help heal wounds faster by showing two ways new skin cells grow to cover wounds in pigs.

## Contribution

The study reveals a dual mechanism of re-epithelialization when using skin cell suspension autografts with meshed grafts.

## Key findings

- Wound interstices showed complete closure as early as 3 days after surgery.
- Keratinocytes migrated from both the edges and centers of the interstices to form new skin layers.
- A high number of proliferating cells in the wound bed supports the regenerative effect of SCSA.

## Abstract

Timely closure of acute, full-thickness wounds is critical in minimizing complications such as infection, fluid loss, and impaired healing, all of which can adversely affect long-term patient outcomes. Although meshed autografting is the current standard of care, its effectiveness is limited by the need for donor skin and the re-epithelialization of expanded interstices. Prior research has shown that combining meshed autografts with skin cell suspension autograft (SCSA) enhances epidermal regeneration. In this study, we further investigate the mechanisms by which SCSA promotes re-epithelialization when applied with a widely expanded (3:1) meshed autograft in a full-thickness porcine wound model. Histological analyses demonstrate complete closure of graft interstices as early as 3 days post-surgery. A dual mechanism of re-epithelialization was observed, with keratinocytes migrating both from the edge of the interstices and from within the center of the interstices to form a continuous epithelial layer. The presence of a high number of proliferating cells in the wound bed further supports the regenerative activity of SCSA. These findings offer valuable mechanistic insight into the role of SCSA in accelerating wound closure and provide additional evidence for its use in improving outcomes for patients with acute full-thickness wounds.