Research associate Yufei Chen demonstrates the 3D bioprinter at the HHS Centre for Burn Research, located at the David Braley Research Institute next door to our Hamilton General Hospital. This printer uses a bioink containing stem cells to create skin substitutes for burn care studies.

November 19, 2024

HHS study could revolutionize care worldwide for patients with extensive burns

Patients with extensive, deep burns are among the sickest people in hospital, with survivors experiencing long-term side effects like disfigurement and scarring causing chronic pain, tightness and itching.

But a stem cell study being launched in the new year at Hamilton Health Sciences (HHS)’ Centre for Burn Research could lead to a less invasive treatment for patients with burns to much of their body, improving their survival and healing rates, and bringing a better quality of life.

“With the launch of the Phase 1 clinical trial, our lab will be the first in the world to treat patients using stem cells taken from their burned skin to help them heal.” — Dr. Marc Jeschke

The Health Canada-approved Phase 1 clinical trial will evaluate the safety and feasibility of using stem cells harvested from the patient’s own burned skin tissue to heal wounds. Until fairly recently, burned tissue was considered medical waste. But researchers now know that burned tissue has value because stem cells can be extracted from it, for potential use in skin grafting to promote skin regeneration and reducing scarring when enough healthy skin isn’t available to treat wounds.

The trial, if successful, could be a game changer for patients with burns to much of their body, where healthy skin needed for treatment isn’t obtainable.

Some burn patients can currently qualify for autologous stem cell treatment, which uses their own stem cells to create new skin regeneration for grafting, when enough healthy skin remains on their body to collect a tissue sample. But it’s not yet an option for extensively burned patients who don’t have enough healthy skin available for treatment.

Dr. Marc Jeschke, HHS vice president of research and chief scientific officer

“With the launch of the Phase 1 clinical trial, our lab will be the first in the world to treat patients using stem cells taken from their burned skin to help them heal,” says Dr. Marc Jeschke, a globally recognized burn surgeon and researcher. Jeschke joined HHS in 2022 and established the HHS Centre for Burn Research. He also serves as vice president of research for HHS and is the hospital’s chief scientific officer.

Jeschke’s lab at the Centre for Burn Research focuses on three key areas of research related to burn treatment: stem cells for skin regeneration; bioprinting where a skin substitute is created using stem cells and printed for grafting wounds, and metabolism studies aimed at improving survival rates, with a focus on older adults.

The centre and lab are located within the Thrombosis and Atherosclerosis Research Institute (TAaRI), located David Braley Research Institute building, next door to HHS Hamilton General Hospital (HGH) where the region’s burn patients receive treatment. It’s one of two burn units in the province, and Jeschke is a surgeon there as well as the HHS Regional Burn Program’s medical director. The burn unit cares for a wide range of patients, from those with small but significant burns to patients with burns to their entire body.

Tour the HHS Centre for Burn Research:

Leading-edge stem cell research

“Our hope, through this trial, is to help patients with deep, extensive burns heal without further surgery and with less side effects like scarring because people heal better with their own stem cells,” says Jeschke.

A lab technician stores tissue samples in a stand-up deep freezer

HHS research technician Graham Rix stores tissue samples in a -80 C freezer.

The trial, launching in early 2025, will recruit 20 HGH patients with burns to less than 20 per cent of their body, to study how skin heals using stem cells extracted from their own burned tissue. If successful, it’s expected to open the door for patients with more widespread deep burns to receive stem cell treatment using their burned tissue for stem cell extraction when enough healthy skin tissue isn’t available.

Lab error leads to major discovery

Just a few years ago, burned skin tissue was considered medical waste. But during a surgery by Jeschke back when he was working at a Toronto hospital, a lab staff member’s error led to a stunning discovery. The staff member mistook a sample of burned skin for healthy skin, and tried to extract stem cells from it. To everyone’s amazement, it worked.

This instigated a groundbreaking study, led by Jeschke and published in 2018, which found that burned skin tissue contained viable, undamaged stem cells that could be extracted and incorporated into wound healing in mice and pigs without adverse side effects. Since pig skin is very close to human skin, this brought new hope for patients with extensive burns.

“It was a very important discovery, particularly for these patients,” says Jeschke, whose lab received Health Canada approval to launch the Phase 1 safety trial in human patients. But that trial, set to launch in 2021 in Toronto, was postponed due to the pandemic. Then in 2022 Jeschke moved to HHS with plans to launch the trial here. This has now been made possible with close to $1 million in funding from the Stem Cell Network and through donors of Hamilton Health Sciences Foundation.

Stem cells collected from Hamilton burn patients in the trial will be sent to the specialized Good Manufacturing Practices Facility (cGMP) in Toronto for creating cell products, then sent back to Hamilton where burn surgeons will use the stem cell product to generate new skin growth over burn wounds.

3D bioprinting

3D bioprinter

The The HHS Centre for Burn Research’s equipment includes a 3D bioprinter, which uses bio ink made of stem cells to create layers of skin tissue for skin grafts. Skin substitutes created with stem cells from burned tissue combined with skin printing could open to door to saving patients with full body burns, says Jeschke.

“It’s currently not possible to save the lives of patients with 100 per cent burns because we need some normal skin from their body in order to treat them,” he says.

“But if we can extract stem cells from burned skin, and then create a skin substitute using skin printing, we could graft it on a patient with a 100 per cent burn. It’s my hope that by the end of my career, a skin printing device will be in place where we can print skin for a patient using their stem cells extracted from healthy or burned skin.”

Burn treatment facts

It has long been understood that the only way to heal burns is with skin, which in parts of the world has included frog skin, onion skin and amniotic membrane.
Skin grafting, where healthy skin is taken from other areas of the body to patch burn wounds, has been the norm for many years to treat serious burns.
1970s: It was discovered that outcomes improve if burned skin is removed from the wound within 72 hours of the burn.
1980s and 90s: Through biotechnology and bioengineering advancements, skin substitutes begin being explored.
Early 2000s: Advancements in stem cell research open the door to the possibility of using skin cells to advance wound healing.