Abstract
As the largest organ in the human body, the skin has the function of maintaining balance and protecting from external factors such as bacteria, chemicals, and temperature. If the wound does not heal in time after skin damage, it may cause infection or life-threatening complications. In particular, medical treatment of large skin defects caused by burns or trauma remains challenging. Therefore, human bioengineered skin substitutes represent an alternative approach to treat such injuries. Based on the chemical composition and scaffold material, skin substitutes can be classified into acellular or cellular grafts, as well as natural-based or synthetic skin substitutes. Further, they can be categorized as epidermal, dermal, and composite grafts, based on the skin component they contain. This review presents the common commercially available skin substitutes and their clinical use. Moreover, the choice of an appropriate hydrogel type to prepare cell-laden skin substitutes is discussed. Additionally, we present recent advances in the field of bioengineered human skin substitutes using three-dimensional (3D) bioprinting techniques. Finally, we discuss different skin substitute developments to meet different criteria for optimal wound healing.
Highlights
Skin is the largest organ and protects the human body against the external environment [1]
Wound healing represents a crucial ability of the human skin to repair any skin defect and to keep proper skin homeostasis
Further disadvantages of Dermagraft are the necessity of multiple applications, safety issues owing to allogeneic cells, and high costs [1]
Summary
Skin is the largest organ and protects the human body against the external environment [1]. Wound healing represents a crucial ability of the human skin to repair any skin defect and to keep proper skin homeostasis. Large and deep skin wounds caused by extensive burns or tissue trauma still pose a significant challenge for the surgeon. If those wounds do not heal in time after skin damage, they might cause infection or life-threatening complications. The ideal skin substitute should have good biocompatibility, antibacterial activity, proper hydrophilicity, and biodegradability [3]. We present commercially available skin substitutes for different clinical applications. We demonstrate various treatment opportunities for skin defects and discuss their advantages and disadvantages to achieve optimal wound healing outcomes.
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