For a standard skin graft, surgeons usually must remove an area of healthy skin no smaller than three-quarters of the size of the wound, then stretch it over the damaged area. “So if a person has burns covering 10 percent of their body, the area of the skin graft that would be required is about equal to a grown adult’s full back,” Perry said.
“You are creating new wounds when you take those skin samples to cover the burn.”
The most serious burns often cause little pain, because the nerves are destroyed along with skin and muscle tissue. But the grafts use the top layers of skin, right where the most nerves are. “These patients are in extraordinary pain,” Perry said. “Taking those skin grafts is just excruciating.”
The ReCell system considerably reduces the amount of healthy skin that must be removed — by 97 percent for a second-degree burn, Perry said.
“If your whole back was burned, all you would need is a piece of skin the size of a credit card to replace that damage,” Houchens said.
The burns heal more quickly and patients end up spending less time in the hospital, he said. Two clinical trials showed quicker recovery using less skin than standard grafts.
It takes about 30 minutes to process a skin sample from a patient, Perry said. Because the cells come from the patient, there is no risk of rejection.
Melancon was very happy with his results. “Overall, I believe it was 34 percent of my body that was burned,” he said. That would normally mean two months or more in the hospital for recovery, with much of that time spent taking narcotics for the pain.
Melancon spent just 3 ½ weeks in the hospital after his June 26 accident. He said he stopped taking pain medication by mid-August so he could start back in his nursing school classes.
“On my knees I had burned essentially down to just bone,” he said. He also lost skin off the areas from which skin grafts are usually harvested: the back, abdominal area and his thighs. “The doctor didn’t have much skin to work with,” Melancon said.
Now, he says, he has very little pain. “I show everyone my grafts and scarring and everyone is surprised at how well it works,” he said. Hair follicles have started growing back in some areas, and in some, he said, scars are barely visible.
“I’m proof that it works,” Melancon said.
Perry said Avita has not settled on a price for the ReCell system, but it will most likely be between $5,000 and $10,000 per unit, which can treat about 10 percent of a patient’s body surface area. Someone with burns over 50 percent of the body would require five units for treatment — more for deeper burns.
BARDA will buy some of the units for the national stockpile of medicines and equipment on standby for big emergencies such as major explosions and chemical or nuclear attacks.
“If you think of a mass casualty event, we don’t have enough beds to be able to treat hundreds of patients at a time,” Houchens told NBC News.
“We don’t have enough burn specialists. Our system will be completely overwhelmed. Having this technology that allows us to treat this in 30 minutes is really transformational.”
BARDA and other federal agencies have been trying to support and encourage researchers to make spray-on skin for years. The agency invested about $50 million in the development of ReCell.
“These products are mostly going to be used by hospitals and by physicians to treat patients who are injured in a house fire or a gas explosion or a car accident,” Houchens said. But, he said, when a company can commercially develop a government-supported product, it should get wider use, which can bring the price down.