Vascularization is the next challenge for skin tissue engineering as a solution for burn management.

Hady Shahin,Moustafa Elmasry,Ingrid Steinvall,Ahmed El-Serafi,Folke Söberg

doi:10.1093/burnst/tkaa022

Hady Shahin, Moustafa Elmasry + Show 3 more

Open Access

https://doi.org/10.1093/burnst/tkaa022

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Journal: Burns & trauma	Publication Date: Jan 1, 2020
Citations: 26	License type: CC BY 4.0

Affiliation: Linköping University

Abstract

Skin regeneration represents a promising line of management for patients with skin loss, including burn victims. The current approach of spraying single cells over the defective areas results in variable success rates in different centers. The modern approach is to synthesize a multilayer skin construct that is based on autologous stem cells. One of the main complications with different types of transplants is sloughing due to the absence of proper vascularization. Ensuring proper vascularization will be crucial for the integration of skin constructs with the surrounding tissues. Combination of the right cells with scaffolds of proper physico-chemical properties, vascularization can be markedly enhanced. The material effect, pore size and adsorption of certain proteins, as well as the application of appropriate growth factors, such as vascular endothelial growth factors, can have an additive effect. A selection of the most effective protocols is discussed in this review.

Highlights

Skin is the largest organ of the body and plays a vital role in homeostasis
Skin regeneration represents a promising line of management for patients with skin loss, including burn victims
Ensuring proper vascularization will be crucial for the integration of skin constructs with the surrounding tissues

Summary

Background

Skin is the largest organ of the body and plays a vital role in homeostasis. The loss of merely 15% of the total body surface area (TBSA) is sufficient to be considered as life-threatening. Incorporation of proangiogenic growth factor gene The concept of a gene-activated matrix involves the pre-treatment of matrices with gene vectors to achieve a sustained DNA delivery to the ingrowing cells at the implantation site [42] This approach improved skin regeneration and vascularization in porcine and rodent models when activated dermal scaffolds were supplemented with plasmids encoding for VEGF [43, 44] and bFGF [45] were used. Application of early outgrowth endothelial progenitor cells improves angiogenesis and epidermal wound healing, which makes these cells possible candidates for skin tissue engineering Despite their defined angiogenic potential, ease of harvest and trophic effect on wound healing, their impaired proliferation capacities may hinder their clinical applicability [66]. These risks are closely related to the production process of iPSCs with viral vectors [99]

Conclusions

Findings

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