Neoskin development in the fetus with the use of a three-layer graft: An animal model for in utero closure of large skin defects

Denise Arajo Lapa Pedreira, Ruben A. Quintero, Gregrio Lorenzo Accio, Elia Tamaso Espin Garcia Caldini, Paulo Hilrio Nascimento Saldiva

Research output: Contribution to journalArticle

13 Scopus citations


Objective: To assess the ability of a three-layer graft in the closuse of large fetal skin defects. Methods: Ovine fetuses underwent a large (4×3cm) full-thickness skin defect over the lumbar region at 105 days' gestation (term=140 days). A bilaminar artificial skin was placed over a cellulose interface to cover the defect (3-layer graft). The skin was partially reapproximated with a continuous nylon suture. Pregnancy was allowed to continue and the surgical site was submitted to histopathological analysis at different post-operative intervals. Results: Seven fetuses underwent surgery. One maternal/fetal death occurred, and the remaining 6 fetuses were analyzed. Artificial skin adherence to the wound edges was observed in cases that remained in utero for at least 15 days. Neoskin was present beneath the silicone layer of the bilaminar artificial skin. Conclusions: Our study shows that neoskin can develop in the fetus using a 3-layer graft, including epidermal growth beneath the silicone layer of the bilaminar skin graft. These findings suggest that the fetus is able to reepithelialise even large skin defects. Further experience is necessary to assess the quality of this repair.

Original languageEnglish (US)
Pages (from-to)1243-1248
Number of pages6
JournalJournal of Maternal-Fetal and Neonatal Medicine
Issue number10
StatePublished - Oct 1 2011



  • Animal
  • Artificial
  • Disease models
  • Fetal therapies
  • Meningomyelocele
  • Prenatal video-assisted surgery
  • Sheep
  • Skin
  • Ultrasonography
  • Wound healing

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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