Bioengineered skin breakthrough to revolutionise burns treatment

Dr Cheng Lo in theatre with a burns patient

Researchers from The Alfred and the Faculty of Medicine, Nursing and Health Sciences are developing bio-engineered skin that will undergo a large trial in third-degree burn patients, starting in 2023.

Victorian Adult Burns Centre director Adjunct Associate Professor Heather Cleland and head of the skin bioengineering laboratory Adjunct Associate Professor Shiva Akbarzadeh spoke to the Herald Sun about the cutting-edge technique. A/Prof Cleland also spoke on ABC Radio's Mornings program.

Congratulations to Associate Professor Shiva Akbarzadeh on her promotion!

Congratulations to Shiva Akbarzadeh on her promotion to Adjunct Associate Professor!

Professor Wendy Brown, Head of Department of Surgery at Central Clinical School, writes:

Shiva Akbarzadeh obtained her PhD from the Ludwig Institute for Cancer Research, University of Melbourne in 2002. She has almost 20 years of experience in cell biology and signalling in a variety of systems. In 2009 she established the Skin Bioengineering Laboratory at the Victorian Adult Burns Service - Alfred Health, focusing on translational research in skin regeneration. She leads the team responsible for manufacturing Cultured Epithelial Autograft for cellular based therapy of major burns and research in developing novel skin substitutes for clinical application.

Position vacant: Research Scientist

Miss Heather Cleland (left) and Dr Shiva Akbarzadeh
(right) work on skin tissue engineering. See more about
the Skin Bioengineering research group

Wanted! A research scientist to join a small and active group of scientists committed to translational research in skin tissue engineering at The Victorian Adult Burns Service, The Alfred, collaborating with Monash University scientists in the field. To be successful for this role you will need to have a PhD in cell biology or equivalent and proven experience in primary cell culture and cell biology techniques. Experience in skin biology, wound healing, platelet biology and mouse models are highly desirable. You will require to work independently and in a team and have a proven track record in producing high quality research outcomes and manuscript preparation.

https://careers.alfredhealth.org.au/job/12422/4XONA904S/research-scientist

Female burns patients fare badly after discharge

Female burns victims have poorer quality
of life than their male counterparts.
Photo: Sunday Night 7 News

by Anne Crawford

Monash University and Alfred Hospital researchers have called for measures to urgently improve the long-term care of female burns patients after a study showed they experienced significantly reduced quality of life compared to men after burn injury.

Monash tests show promising results for synthetic skin

L-R: Dr Marisa Herson, Dr Shiva Akbarzadeh, Ms Michelle Paul,
Ms Heather Cleland, Director Victorian Adult Burns Service (VABS);
Ms Lipi Shukla. Absent: Dr Perdita Cheshire

by Anne Crawford

Dermal substitution (artificial skin) plays an important role in wound reconstruction after deep burns and injuries, providing a temporary seal to guard against infection and acting as a scaffold for tissue repair. Monash University researchers compared a fully synthetic alternative manufactured in Melbourne to an existing animal-derived product.

30 Jun deadline: MIME PhD Scholarship available for regenerative medicine (burns)

Applications due 30 June for a PhD project scholarship in regenerative medicine: Development of an engineered skin substitute for the treatment of burn injuries

The prognosis for survival of burn injuries has improved significantly in the last 40 years. This has in large part been due to improvements in the critical care of patients with a severe burn injury, and patients now routinely survive injuries that were inevitably fatal in the 1970s. However, further improvements in burn care are currently significantly impeded by the lack of a true skin substitute that replicates the functions of intact skin. This is despite the development of biosynthetic dressings, temporary skin substitutes and dermal analogues that have provided adjunctive treatments to split skin grafts, which remain the gold standard for large wound closure in most settings.

Building the evidence base for burns care with BRANZ

Miss Heather Cleland with a patient. She is Director of the
Victorian Adult Burns Service at Alfred Health.

The Burns Registry of Australia and New Zealand (BRANZ) is providing crucial data to burn units across the region, improving practice and outcomes for patients, according to research published in the Medical Journal of Australia (MJA) on the first four years of data from BRANZ.

20 Oct Australian & New Zealand Burn Association Scientific Forum

The Australian and New Zealand Burn Association (ANZBA) are holding their 39th annual scientific meeting 20-23 October 2015.

This year the focus of the one day scientific forum (held on 20 October) will be on cellular therapies and skin substitutes in the treatment of burns. The morning session will provide an overview of cell therapies (including those that could impact on burn care) and the 'bench to bedside' journey hurdles. Presenters will be experts in cell culture and tissue engineering.

The afternoon session  will start with a presentation from a representative from the Australian Therapeutic Goods Administration, to be followed by a series of clinical investigators describing their own experience in translational laboratory work, and in establishing and running clinical trials in burn related cell derived therapies and dermal substitutes. Ms Heather Cleland and Dr Shiva Akbarzadeh, Department of Surgery, will be amongst the presenters.

The scientific forum is designed to:

• showcase the range of experimental work being performed by ANZBA and other clinicians in the area of burn care
• gain an overview of different strategies being pursued and possible collaborations
• improve understanding of potential hurdles and pitfalls in developing and applying new technologies for clinical treatment

It is hoped that the opportunities for discussion and sharing of experience and knowledge will promote and enhance research in this vital area.

Conference registrants as well as day registrants are welcome to attend and contribute to the forum.

For more information and how to book visit www.anzbaasm.com

Crowdfunding boost for burns victims: Your vote counts!

Dr Shiva Akbarzadeh's Thinkable.org entry - Please vote!

You can help medical research at Monash win a cash prize by voting for it in the Thinkable 'Inspire Australia' competition.

New skin substitutes tailor-made for severe burns victims could become a reality through the work of a group of scientists led by Dr Shiva Akbarzadeh, and a boost from crowdfunding site, Thinkable.

Dr Akbarzadeh, a skin biologist at The Alfred hospital and Monash University, researches growing artificial skin in the laboratory using patients’ own cells that can be applied instead of skin grafts.

“The gold standard for treating deep burns is skin grafts,” Dr Akbarzadeh said. “That is difficult when a patient has massive burns and not enough donor sites, as happens in extensive burns.”

Dr Akbarzadeh’s Skin Tissue Culture Laboratory has developed techniques to create composite skin in the laboratory that is close to native skin.

“Our goal is to enable surgeons to replace both dermal and epidermal layers of damaged skin with tissue engineered skin in a single procedure. This will speed up wound healing and reduce the risk of infection.

“We are collaborating with material engineers at Monash to develop novel dermal matrices which are made from natural dermal components and would enhance epidermisation both in laboratory incubators and on patients.”

The work of Dr Akbarzadeh and her team could come to full fruition with the help of the Australian Academy of Science’s Australian Early to Mid-Career Researcher Forum which has launched the Inspire Australia Video Research Competition on research crowdfunding and engagement platform, Thinkable.

With close to $15,000 in the community prize pool so far, Dr Azbarkadeh’s lab, as well as other research teams in the Thinkable community, stand to gain a share, according to their overall votes received, all going towards general funding to advance their work.

To support the work of Dr Azbarkadeh and her team, visit their Thinkable ‘Tissue engineering for burns treatment’ video page to vote and contribute. Voting ends 30 July 2015.
To find out more about how Thinkable works, visit the Thinkable.org website.

Burns wound dressing using a synthetic skin substitute

Use of synthetic skin substitute
for dressing burn wounds

The Victorian Adult Burns Service (VABS) has a cadaver skin bank. However, due to issues surrounding cost, graft rejection, disease transfer and limited availability, Biobrane - a synthetic skin substitute - is the preferred temporary wound dressing for uncontaminated excised wounds in the VABS unit. The use of Biobrane has been incorporated into the unit's surgical treatment algorithm. Biobrane may be considered an expensive wound closure option, but a recent study suggests it is more cost and time-effective than cadaveric allograft when used as a temporary wound closure method. 

Reference: Tan H, Wasiak J, Paul E, Cleland H. Effective use of Biobrane as a temporary wound dressing prior to definitive split-skin graft in the treatment of severe burn: A retrospective analysis. Burns 41(5) pp.969-976. dx.doi.org/10.1016/j.burns.2014.07.015

Improving wound treatment with tissue-engineered composite skin

The Skin Tissue Culture Laboratory group, Alfred and Monash.
L-R: Dr Marisa Herson, Dr Shiva Akbarzadeh, Ms Michelle
Paul, Ms Heather Cleland, Director Victorian Adult Burns
Service (VABS); Ms Lipi Shukla, PhD student

Tissue-engineered composite skin is a promising therapy for treatment of chronic and acute wounds, including burns. Providing the wound bed with a dermal scaffold populated by autologous dermal and epidermal cellular components can further entice host cell infiltration and vascularisation to achieve permanent wound closure in a single-stage.

Tissue engineering for treatment of burn wounds: Phase 1 clinical trial running

L-R: In the Skin Tissue Culture Laboratory, Mr Dion Martinus
(Quality Officer), Ms Heather Cleland (Director, Burns Unit)
and Dr Shiva Akbarzadeh (Senior Research Fellow)

The Alfred Skin Tissue Culture Laboratory pursues a translational research program directed towards the investigation and development of tissue engineered products for wound healing.

A phase 1 clinical trial evaluating the use of cultured keratinocytes as an adjunctive therapy for patients with severe burns commenced recruitment in 2014. To date, five patients have been recruited.

Research: Investigating the biology of skin grafts for burns treatment

Heather Cleland's group in the Skin Culture Laboratory, Victorian Adult Burns Service and Department of Surgery, Monash University, The Alfred Hospital have found that cadaver skin which has been frozen has, on analysis, a "positive and definite role as an adjunct to conventional dressing and grafting where available, particularly in patients with large TBSA [total body surface area] burns." Tissue viability in cadaveric allograft may not be essential for its clinical function as a wound dressing or even as permanent dermal substitute.
Reference: http://www.ncbi.nlm.nih.gov/pubmed/24018216