Mechanisms of cryoinjury and cryoprotection in split-thickness skin.

Successful cryopreservation of tissues will ultimately require a more detailed understanding of how the in situ environment modifies cell responses during cooling and warming. Low-temperature responses of porcine split-thickness skin and isolated basal keratinocytes were compared after various cooling protocols and in the presence and absence of cryoprotectants. Recovery was assessed by measuring oxygen consumption kinetics in skin and tetrazolium reduction in isolated cells. Freeze substitution was used to visualize ice nucleation and growth in skin. The results indicated that the time required for diffusion of water in split-thickness skin delayed osmotic responses in the basal keratinocytes and resulted in increased intracellular and intercellular ice formation. Rapid cooling (-200 degrees C/min) in the presence of cryoprotectants resulted in a reduction in the number of cells containing ice and the size of the intercellular ice crystals and an increase in tissue recovery. These observations support other reports which suggest that cell-to-cell and cell-to-substrate interactions are sensitive sites for cryoinjury. A practical recommendation from this study is that high recovery of split-thickness skin may be achieved with protocols using high cooling rates.