S16 Burns (1992) IS, Supplement 1, S16-S18 zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Printed in Great Briiain Rheinwald J. G. and Green H. (1975b) Serial cultivation of strains of human epidermal keratinocytes: the formation of keratinizing colonies from single cells. Cell 6, 331. Rheinwald J. G. and Green H. (1977) Epidemal growth factor and the multiplication of cultured human epidemal keratinocytes. Nature 265, 421. Shipley G. D. and Pittelkow M. R. (1987) Control of growth and differentiation in vitro of human keratinocytes cultured in serum-free medium. Arch. Dermalol. 123, 1541. Stanulis-Praeger B. M., Yaar M., Redziniak G. et al. (1988) An extract of bovine thymus stimulates human keratinocytes growth in vitro. 1, Imesf. Dermafol. 90, 749. Stenn K. S., Madri J. A., Tinghitella T. et al. (1983) Multiple mechanism of dissociated epidennal cell spreading. 1. Cell Biol. 96, 63. Thivolet J., Faure M., Demidem A. et al. (1986) Long-term survival and immunological tolerance of human epidermal allografts produced in culture. Transplankakion 42, 274. Tinois E., Faure M., Chatelain P. et al. (1987) Growth and differentiation of human keratinocytes on extracellular matrix. Arch. Demakol. Res. 279, 241. Tsao M. C., Walthall B. J. and Ham R. G. (1982) Clonal growth of normal human epidermal keratinocytes in a definied medium. I. Ce// Physiol. 110, 219. Vaughan F., Gray R. H. and Bernstein I. A. (1986) Growth and differentiation of primary rat keratinocytes on synthetic mem- branes In Vitro Cell Develop. Biol. 22, 141. Watt F. M. (1988) Epidermal stem cells in culture. 1. Cell. Sri. Suppl. 10, 85. Wille J. J., Pittelkow M. R., Shipley G. D. et al. (1984) Integrated control of growth and differentiation of normal human prokera- tinocytes cultured in serum-free medium: clonal analyses, growth kinetics and cell cycle studies. 1. Cell Physiol. 121, 31. Correspondence should be addressed to: Professor Maria Luisa Ten- chini, Dipartimento di Biologia e Genetica per le Scienze mediche, via Viotti 5, I - 20133 Milano, Italy. Permanent coverage of full skin thickness burns with autologous cultured epidermis and re-, epithelialization of partial skin thickness lesions induced by allogetieic cultured epidermis: a multicentre study in the treatment of children M. De Lucalfz, S. Bondanzal”, R. Cancedda”‘, A. M. Tamisani3, C. Di Noto3, L. Muller’, D. Dioguardl “, E. Brienza4, A. Calvario4, R. Zermani5, D. Di Mascio5 and F. Papadia5 ‘IST, Istituto Nazionale per la Ricerca sul Cancro, Genoa, ‘Istituto di Oncologia Clinica e Sperimentale, Universita’ di Genova, Genoa, 3Servizio Chirurgico di Pronto Soccorso, Istituto Giannina Gaslini, Genoa, *Cattedra di Chirurgia Plastica, Facolta’ di Medicina e Chirurgia, Universita’ di Bari, Bari and Ystituto di Chirurgia Plastica e Centro Ustioni, Facolta’ di Medicina e Chirurgia, Universita’ di Par-ma, Parma, Italy Introduction When burn wounds cover large areas of the body surface, remaining donor sites might not be sufficient to prepare enough split-thickness mesh grafts. This problem becomes more critical in children since the use of large donor sites increases the skin defect and, especially in patients sustain- ing large burn wounds, might actually increase the mortality rate. Moreover, hypertrophic scars develop frequently on the donor sites in children. Skin-derived human keratino- cytes can be cultured in vitro (Rheinwald and Green, 1973, starting from a 1-2 cm2 biopsy. With the appropriate culture conditions, the initial cell population present in the skin $” 1992 Butterworth-Heinemann Ltd 0305-4179/92/OSOS1&03 biopsy can be amplified in secondary cultures and can generate coherent epithelial sheets sufficient to cover the entire body surface in a period of 2-4 weeks (Green et al., 1979; De Luca et al., 1989). Autologous epithelial sheets (autografts) can be detached from the surface vessel and successfully used for permanent coverage of large burn wounds (O’Connor et al., 1981; Gallico et al., 1984; Cuono et al., 1986; Faure et al., 1987; Herzog et al., 1988; De Luca et al., 1989; Teepe et al., 1990a). Recovery of children sustaining full skin thickness bums covering up to 98 per cent of the body surface has been reported (Gallico et al., 1984). However, levels of ‘take’ (i.e. the presence of viable epithelium at the removal of the petroleum jelly gauze)