{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:49:51Z","timestamp":1790106591446,"version":"4.0.1"},"reference-count":23,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2017,12,25]],"date-time":"2017-12-25T00:00:00Z","timestamp":1514160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Cultured epithelial autografts (CEA) with highly expanded mesh skin grafts were used for extensive adult burns covering more than 30% of the total body surface area. A prospective study on eight patients assessed subjective and objective findings up to a 12-month follow-up. The results of wound healing for over 1:6 mesh plus CEA, gap 1:6 mesh plus CEA, and 1:3 mesh were compared at 3, 6, and 12 months using extensibility, viscoelasticity, color, and transepidermal water loss by a generalized estimating equation (GEE) or generalized linear mixed model (GLMM). No significant differences were observed among the paired treatments at any time point. At 6 and 12 months, over 1:6 mesh plus CEA achieved significantly better expert evaluation scores by the Vancouver and Manchester Scar Scales (p &lt; 0.01). Extended skin grafting plus CEA minimizes donor resources and the quality of scars is equal or similar to that with conventional low extended mesh slit-thickness skin grafting such as 1:3 mesh. A longitudinal analysis of scars may further clarify the molecular changes of scar formation and pathogenesis.<\/jats:p>","DOI":"10.3390\/ijms19010057","type":"journal-article","created":{"date-parts":[[2017,12,26]],"date-time":"2017-12-26T03:06:38Z","timestamp":1514257598000},"page":"57","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Novel Application of Cultured Epithelial Autografts (CEA) with Expanded Mesh Skin Grafting Over an Artificial Dermis or Dermal Wound Bed Preparation"],"prefix":"10.3390","volume":"19","author":[{"given":"Sadanori","family":"Akita","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Wound Repair and Regeneration, School of Medicine, Fukuoka University, Fukuoka 814-0180, Japan"},{"name":"Department of Plastic and Reconstructive Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6257-1808","authenticated-orcid":false,"given":"Kenji","family":"Hayashida","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan"},{"name":"Division of Plastic and Reconstructive Surgery, Shimane University Hospital, Shimane 693-0021, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Yoshimoto","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Fujioka","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki 856-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikako","family":"Senju","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan"},{"name":"Department of Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki 856-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Morooka","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki 856-8562, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gozo","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Fukuoka Tokushukai Hospital, Fukuoka 816-0864, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiko","family":"Mukae","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Kitakyushu General Hospital, Kitakyushu 802-8517, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Ehime Prefectural Central Hospital, Ehime 790-0024, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuniaki","family":"Anraku","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Sasebo City General Hospital, Sasebo 857-0056, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuichi","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Yamaguchi Prefectural Grand Medical Center, Osaki 747-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiyoshi","family":"Hirano","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masao","family":"Oishi","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Ikenoya","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Matsue Red Cross Hospital, Matsue 690-8506, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Amano","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Yamaguchi Prefectural Grand Medical Center, Osaki 747-8511, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Ehime Prefectural Central Hospital, Ehime 790-0024, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Nagasaki University plastic surgeons group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,12,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/00005373-198702000-00019","article-title":"Effect of early excision on patients with major thermal injury","volume":"27","author":"Thompson","year":"1987","journal-title":"J. Trauma"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S318","DOI":"10.1097\/CCM.0b013e31817e2d64","article-title":"Advances in surgical care: Management of severe burn injury","volume":"36","author":"White","year":"2008","journal-title":"Crit. Care Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/S0140-6736(83)90392-6","article-title":"Grafting of burn patients with allografts of cultured epidermal cells","volume":"2","author":"Hefton","year":"1983","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1016\/j.burns.2011.03.011","article-title":"Cultured epithelial autografts in massive burns: A single-center retrospective study with 63 patients","volume":"37","author":"Cirodde","year":"2011","journal-title":"Burns"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1097\/SAP.0b013e3182840883","article-title":"Clinical application of cultured epithelial autografts on acellular dermal matrices in the treatment of extended burn injuries","volume":"73","author":"Fang","year":"2014","journal-title":"Ann. Plast. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/j.burns.2016.01.019","article-title":"Application of the cultured epidermal autograft \u201cJACE\u00ae\u201d for treatment of severe burns: Results of a 6-year multicenter surveillance in Japan","volume":"42","author":"Matsumura","year":"2016","journal-title":"Burns"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"5665","DOI":"10.1073\/pnas.76.11.5665","article-title":"Growth of cultured human epidermal cells into multiple epithelia suitable for grafting","volume":"76","author":"Green","year":"1979","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/SAP.0000000000000200","article-title":"Experience of using cultured epithelial autografts for the extensive burn wounds in eight patients","volume":"73","author":"Hayashi","year":"2014","journal-title":"Ann. Plast. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1016\/j.burns.2014.03.002","article-title":"Longitudinal burn scar quantification","volume":"40","author":"Nedelec","year":"2014","journal-title":"Burns"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1097\/BCR.0b013e3181710881","article-title":"Quantitative measurement of hypertrophic scar: Interrater reliability and concurrent validity","volume":"29","author":"Nedelec","year":"2008","journal-title":"J. Burn Care Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"10S","DOI":"10.1177\/0363546509350694","article-title":"Treatment of symptomatic cartilage defects of the knee","volume":"37","author":"Saris","year":"2009","journal-title":"Am. J. Sports Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"382","DOI":"10.3945\/ajcn.110.004515","article-title":"Genetic variants in the FADS gene cluster are associated with arachidonic acid concentrations of human breast milk at 1.5 and 6 mo postpartum and influence the course of milk dodecanoic, tetracosenoic, and trans-9-octadecenoic acid concentrations over the duration of lactation","volume":"93","author":"Lattka","year":"2011","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Jacka, F.N., Cherbuin, N., Anstey, K.J., Sachdev, P., and Butterworth, P. (2015). Western diet is associated with a smaller hippocampus: A longitudinal investigation. BMC Med., 13.","DOI":"10.1186\/s12916-015-0461-x"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/0305-4179(94)00008-5","article-title":"A review of skin meshers","volume":"21","author":"Vandeput","year":"1995","journal-title":"Burns"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"437","DOI":"10.3727\/096368915X689569","article-title":"Outcome of Burns Treated With Autologous Cultured Proliferating Epidermal Cells: A Prospective Randomized Multicenter Intrapatient Comparative Trial","volume":"25","author":"Gardien","year":"2016","journal-title":"Cell Transplant."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1265\/jjh.23.443","article-title":"Studies on the Physical Surface Area of Japanese","volume":"23","author":"Fujimoto","year":"1968","journal-title":"Jpn. J. Hyg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1097\/00004630-199005000-00014","article-title":"Rating the burn scar","volume":"11","author":"Sullivan","year":"1990","journal-title":"J. Burn Care Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1097\/00006534-199811000-00022","article-title":"A new quantitative scale for clinical scar assessment","volume":"102","author":"Beausang","year":"1998","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1177\/1534734614541544","article-title":"Lipid-colloid dressing shows improved reepithelialization, pain relief, and corneal barrier function in split-thickness skin-graft donor wound healing","volume":"13","author":"Tanaka","year":"2014","journal-title":"Int. J. Low Extrem. Wounds"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1109\/TPAMI.2004.36","article-title":"Spectral filter optimization for the recovery of parameters which describe human skin","volume":"26","author":"Preece","year":"2004","journal-title":"IEEE Trans. Pattern Anal. Mach. Intell."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1097\/00042728-200801000-00006","article-title":"The evaluation of relevant factors influencing skin graft changes in color over time","volume":"34","author":"Kim","year":"2008","journal-title":"Dermatol. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1067\/mjd.2000.105165","article-title":"Ultraviolet A1 (340\u2013400 nm) phototherapy for scleroderma in systemic sclerosis","volume":"43","author":"Morita","year":"2000","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.burns.2003.09.003","article-title":"Skin elasticity meter or subjective evaluation in scars: A reliability assessment","volume":"30","author":"Draaijers","year":"2004","journal-title":"Burns"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/19\/1\/57\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:55:31Z","timestamp":1760208931000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/19\/1\/57"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,25]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,1]]}},"alternative-id":["ijms19010057"],"URL":"https:\/\/doi.org\/10.3390\/ijms19010057","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,25]]}}}