Skin regeneration, repair, and reconstruction: present and future

Abstract

Summary Background Large skin defects caused by trauma (e.g., burns) or due to other reasons (e.g., tumor-related skin resections) require sufficient skin replacement. The constant improvement of innovative methods of skin replacement and skin expansion mean that even burn victims with more than 80% body surface burned have a realistic chance of survival. Due to these new developments, not only has survival rate increased, but also quality of life has increased tremendously over the past decades. Methods The aim of this review is to present an overview of current standards and future trends concerning the treatment of skin defects. The main focus is placed on the most important technologies and future trends. Results Autologous skin grafting was developed more than 3500 years ago. Several approaches and techniques have been discovered and established in burn care and plastic surgery since then. Great achievements were made during the 19th and 20th centuries. Many of these old and new techniques are still part of modern burn and plastic surgery. Today, autologous skin grafting is still considered to be the gold standard for many wounds, but new technologies have been developed, ranging from biological to synthetic skin replacement materials. Conclusion Today, old and new technologies are available which allow us new treatment concepts. All this has led to the reconstructive clockwork for reconstructive surgery of the 21st century.

Porphyrins—valuable pigments of life

“…During the last decades, various approaches regarding the treatment and healing of skin defects have been explored (Takeo et al, 2015;Kamolz et al, 2022). The query though that frequently rises in clinical trials, is which treatment plan can be followed in each individual trauma.…”

“…In many cases, a period of treatment with an effective agent is followed by the application of an alternative agent, since the wound healing process reaches a plateau (Seaman, 2002). Surgical procedures are arguably the most effective strategy to deal with widespread skin defects, namely, xenografts, autologous full-or split-thickness and allografts (Kamolz et al, 2022). However, apart from the aforementioned surgical techniques, hydrogels have also been extensively studied due to their unique features in healing skin defects (Loo et al, 2014).…”

Managing Vascular Pedicle Exposure in Free Tissue Transfer Using a Reprocessed Micronized Dermal Substitute in Lower Extremity Reconstructions

“…Another recent advancement in reconstructive surgery is the introduction of artificial dermal matrix (ADM) [ 5 , 6 , 7 ]. Serving as a biological scaffold in the wound healing process, it facilitates neovascularization, fibroblast infiltration, and improved re-epithelialization [ 8 , 9 ].…”

Chitosan-Based Membranes for Skin Wound Repair in a Dorsal Fold Chamber Rat Model

“…Available options are limited, frequently entail donor site morbidity (as in the case of autologous skin grafts or flaps) and are often costly (in the case of alloplastic reconstructive options) [4][5][6]. There is a wide range of alloplastic materials available both for research and clinical purposes, including multiple polymers and polymer composites (such as silicone, polylactic compounds, polyurethane, polycaprolactone, polytetrafluoroethylene, and high-density polyethylene), as well as naturally occurring materials, namely cellulose and silk proteins [7,8]. Despite these options, in the clinical setting, the implantation of devices composed of these materials has been associated with several complications, such as infection, extrusion, displacement, local irregularity, and hematoma formation [8].…”

“…Conventional alloplastic methods used in the treatment of skin wounds provide, most of the time, a temporary cover until tissue or cell grafting can be performed or another solution provided [6,10,11]. A possible alternative is the use of 3D skin scaffolds capable of mimicking the structure and biological functions of the extracellular matrix, as well as providing a suitable environment for cells to attach, proliferate and differentiate, protecting the wound with no additional intervention [7,12].…”