Our study was the first and only study comparing the effect of a tissue-engineered skin with an autograft. Each patient served as his or her own control, having their 3 donor sites treated with autograft, LSE (Apligraf; Organogenesis Inc, Canton, Mass), and polyurethane film. The LSE and autograft performed very similarly when placed on acute partial-thickness donor sites, both healing more rapidly than the site treated with polyurethane film. The autograft was, in fact, some of the same skin removed to make the donor site wound on which it was placed! As pointed out by Epstein, we did not prove that the living cells in the LSE played an active role in the healing process. The study was not designed to prove that living cells played an active role in the healing process. We also did not prove that living cells in the autograft played an active role in the healing process. Since both LSE- and autograft-treated acute partial-thickness wounds healed more rapidly than the occlusive film–treated sites, we might have fairly speculated that the living cells in the LSE and autograft accounted for the difference, although we did not make such a speculation.
Eaglstein WH, Kerdel F, Elgart G, Kirsner R, Muhart M. A Controlled Trial, LSE vs Killed LSE, Is Needed—Reply. Arch Dermatol. 2000;136(4):555-556. doi: