Tissue engineering of cultured skin substitutes

Abstract

Skin replacement has been a challenging task for surgeons ever since the introduction of skin grafts by Reverdin in 1871. Recently, skin grafting has evolved from the initial autograft and allograft preparations to biosynthetic and tissue-engineered living skin replacements. This has been fostered by the dramatically improved survival rates of major burns where the availability of autologous normal skin for grafting has become one of the limiting factors. The ideal properties of a temporary and a permanent skin substitute have been well defined. Tissue-engineered skin replacements: cultured autologous keratinocyte grafts, cultured allogeneic keratinocyte grafts, autologous/allogeneic composites, acellular biological matrices, and cellular matrices including such biological substances as fibrin sealant and various types of collagen, hyaluronic acid etc. have opened new horizons to deal with such massive skin loss. In extensive burns it has been shown that skin substitution with cultured grafts can be a life-saving measure where few alternatives exist. Future research will aim to create skin substitutes with cultured epidermis that under appropriate circumstances may provide a wound cover that could be just as durable and esthetically acceptable as conventional split-thickness skin grafts. Genetic manipulation may in addition enhance the performance of such cultured skin substitutes. If cell science, molecular biology, genetic engineering, material science and clinical expertise join their efforts to develop optimized cell culture techniques and synthetic or biological matrices then further technical advances might well lead to the production of almost skin like new tissue-engineered human skin products resembling natural human skin.

Amnion Membrane Graft Dressing in Superficial Partial Thickness Burn in Pediatric Patients

“…They observed that increased rate of re-epithelisation of partial thickness superficial burn by the use of amniotic membrane 4 . This stimulatory effect of on epithelisation & has been considered to be mediated by growth factors and progenic for cell released by amniotic membrane 9,10,11 . …”

Concise Review: Epidermal Grafting: The Case for Pluripotent Stem Cells

“…Allogeneic epidermal cell grafts have not been implemented as an alternative to cultured autografts in large burns, largely because adult cells-in contrast to fetal ones [13]-are highly immunogenic and are not, therefore, an option for a permanent substitute in large burns [14,15]. In contrast, allogeneic cell therapy products have been successfully developed for temporary replacement that is taking into account the short lifespan of the grafted cells.…”

Advanced Trends in Treatment of Wounds

“…When introduced into the body they start degrading and leave behind a matrix of connective tissues having similar properties as that of the dermis. The effects of collagen on dermal wound healing and its combination with anti-microbial agents have been reported 51 . It was observed that it increased the formation of granulation tissue during wound healing.…”