Cytotoxicity testing of wound dressings using normal human keratinocytes in culture.

Comparative cytotoxicity testing of 16 wound dressings of different composition show that normal human keratinocytes (NHK) growing on a fibroblastic feeder layer are as sensitive to toxic materials by direct contact as the confluent MRC5 fibroblasts used for standard cell culture cytotoxicity testing, and slightly more sensitive when extracts of the dressings were tested. After direct contact with each of the cell types, we found effects due to 12 dressing samples (75%), but the extracts of only 6 of them induced changes in cell shape or cell death on NHK, and 4 of them on MRC5 cells. In order to assess the compatibility of these dressings with a pure population of epidermal cells, the cell type responsible for reepidermization of healing wounds, we then tested the sensitivity, both to dressing samples and extracts, of normal human keratinocytes (NHK) grown in chemically defined medium and without a feeder layer: The results show epidermal cytocompatibility of 10 dressing extracts, while 6 others induced cytopathic effects. Three of these extracts specifically damaged epidermal cells and inhibited their proliferation. When comparing the sensitivities of NHK (in defined medium) and MRC5 cells, we observed complete correlation for 75% of the dressings by extract testing and in 94% of the cases after direct contact.