The Role of Cell-Based Therapies in Acute Burn Wound Skin Repair: A Review

Abstract

Tissue engineering solutions for skin have been developed over the last few decades with a focus initially on a two-layered structure with epithelial and dermal repair. An essential element of skin restoration is a source of cells capable of differentiating into the appropriate phenotype. The need to repair areas of skin when traditional techniques were not adequate addressed led to cell based therapies being developed initially as a laboratory-based tissue expansion opportunity, both as sheets of cultured epithelial autograft and in composite laboratory-based skin substitutes. The time to availability of the cell-based therapies has been solved in a number of ways, from using allograft cell-based solutions to the use of point of care skin cell harvesting for immediate clinical use. More recently pluripotential cells have been explored providing a readily available source of cells and cells which can express the broad range of phenotypes seen in the mature skin construct. The lessons learnt from the use of cell based techniques has driven the exploration of the use of 3D printing technology, with controlled accurate placement of the cells within a specific printed construct to optimise the phenotypic expression and tissue generation.

Living Skin Substitute Tissue—Is a Replacement for the Autograft Possible?

“…The search for a one-stage, off-the-shelf, readily available bilayered skin substitute for coverage of large burns has been ongoing for decades, and yet the ideal human skin replacement does not yet exist. Many attempts to create an ideal substitute have been reviewed extensively elsewhere [1][2][3][4]. Given no perfect option, it is imperative that we rethink what is necessary as an alternative to autologous skin grafting.…”