Skin Substitutes in Wound Healing and the Stimulatory Effects of Adipose-Derived Stem Cells for the Proliferation of Keratinocytes on Chitosan

Abstract

In the field of tissue engineering and reconstruction, the development of efficient biomaterial is in high demand to achieve uncomplicated wound healing. Chronic wounds and excessive scarring are the major complications of tissue repair, and, as this inadequate healing continues to increase, novel therapies and treatments for dysfunctional skin repair and reconstruction are important. Skin substitutes that aid in the closure of extensive wounds with no scarring is the ultimate goal in the field of tissue engineering. The ideal skin substitute is still on high demand to achieve effective and scar-free wound healing. This paper reviews the various aspects of the complications related to wound healing and widely used skin substitutes and focuses on chitosan because of its unique function in accelerating wound healing. The proliferation of keratinocytes is essential for wound closure, and adipose-derived stem cells (ASCs) play a significant role in wound healing. ASCs were used to treat deep burns, skin radiation injuries, and even nonhealing wounds like diabetic ulcers. The usage of cultured cells on skin substitutes exactly mimics the skin which promotes the release of growth factors, cytokines, and chemokines. Thus, chitosan in combination with keratinocytes and adipose-derived stem cells may act as a vehicle for delivering cells, which would increase the proliferation of keratinocytes and help complete recovery from injuries.