Pennsylvania state trooper Matt Uram was talking with his wife at a July Fourth party in 2009 when a misjudged spray of gasoline burst through a nearby bonfire and set him alight. Flames covered the entire right side of his body, and after he fell to the ground to smother them, his wife beat his head with her bare hands to put out his burning hair. It was only on the way to the ER, as the shock and adrenaline began to wear off, that the pain set in. “It was intense,” he says. “If you can imagine what pins and needles feel like, then replace those needles with matches.”
From the hospital, Uram was transferred to the Mercy Burn Center in Pittsburgh, where doctors removed all of the burned skin and dressed his wounds. It was on the border between a second- and third-degree burn, and he was told to prepare for months of pain and permanent disfigurement. Not long after this assessment, however, a doctor asked Uram if he would be willing to take part in an experimental trial of a new device.
The treatment, developed by German researcher Dr. Jörg Gerlach, was the world’s first to use a patient’s stem cells to directly heal the skin. If successful, the device would mend Uram’s wounds using his body’s ability to regenerate fully functioning skin. Uram agreed to the procedure without hesitation.
Five days after the accident, surgeons removed a small section of undamaged skin from Uram’s right thigh—about the size of a postage stamp—and used it to create a liquid suspension of his stem cells that was sprayed in a fine mist onto the damaged skin. Three days later, when it was time to remove the bandages and re-dress the wounds, his doctor was amazed by what he saw. The burns were almost completely healed, and any risk of infection or scarring was gone.
A study subsequently published in the scientific journal Burns described how the spray was able to regrow the skin across the burn by spreading thousands of tiny regenerative islands, rather than forcing the wound to heal from its edge to the inside. The technique meant “reducing the healing time” and “minimizing complications,” with “aesthetically and functionally satisfying outcomes,” the paper stated.
Dozens more burn victims in Germany and the U.S. were successfully treated with the spray following Uram’s procedure, and in 2014 Gerlach sold the technology to RenovaCare. The medical technology startup has now transformed the proof-of-concept device from a complicated prototype into a user-friendly product called a SkinGun, which it hopes clinicians will be able to use outside of an experimental setting. For that to happen, RenovaCare is preparing clinical studies for later this year, with the aim of Food and Drug Administration approval for the SkinGun.
Once these obstacles are overcome, RenovaCare CEO Thomas Bold believes, the SkinGun can compete with, or even replace, today’s standard of care.
Current treatment of severe burns involves transplanting healthy skin from one area of the body and stitching it to another in a process called skin grafting or mesh skin grafting. It is a painful procedure that creates an additional wound at the donor site and can cause restricted joint movement because the transplanted skin is unable to grow with the patient. It is able to cover an area only two to three times as large as the harvested patch. “The current standard of care is just horrible,” says Bold. “We are part of regenerative medicine—it is the medicine of the future and will be life-changing for patients.”
Beyond regulatory matters, there are also limitations to the technology that make it unsuitable for competing with treatments of third-degree burns, which involve damage to muscle and other tissue below the skin. Still, stem cell researcher Sarthak Sinha believes that while the SkinGun may not be that advanced yet, it shows the vast potential of this form of regenerative medicine. “What I see as the future of burn treatment is not skin repair but rather functional regeneration of skin and its appendages—such as hair follicles, glands and fat,” says Sinha. “This could be achieved by engaging deeper layers of skin and its resident stem cells to partake in tissue regeneration.”
Research is already underway at RenovaCare to enable treatment of third-degree burns, which Bold describes as “definitely within the range of possibility.” Bold claims the adaptations to the SkinGun would allow it to treat other damaged organs using a patient’s stem cells, but for now the company is focusing solely on burns and wounds to skin—the largest organ of the human body.
Uram’s burns are now completely unnoticeable. There is no scar tissue or even pigment discoloration, and the regenerated skin even tans. “If I show someone where I was burnt, I bet $100,000 they couldn’t tell,” he says. “There’s no scars, no residual pain; it’s like the burn never happened. It’s a miracle.”
Uram is frustrated that the treatment is not available to other burn victims, particularly children. “I want to see the FDA get off their butts and approve this,” he says. “A grown man like me to be scarred is OK, but think about the kids that have to live the rest of their lives with pain and scarring. That’s not OK.”