Technology update Advances in tissue-engineered skin substitutes


THE DEVELOPMENT OF SKIN SUBSTITUTES Xenografts in the form of frog skin were fi rst used to provide wound coverage as early as 1,500 BC[8] and a product made from the skin of the bullfrog is still used in certain parts of the world such as Vietnam and South America[9]


. Water lizard skin was also used in Western culture in the 1600s[8] .


More recently, in the 20th century rabbit, dog and pig skin gained acceptance. As the understanding of immunology and


principles of critical care management has increased, patients with extensive burns are now surviving well beyond the acute phase[10]


This has paved the way for the development of homografts in the form of cadaveric skin and autografts. Subsequently, evolving technologies led to the production of tissue- engineered skin substitutes (TESS). The fi rst transplantation of cultured


epidermal autograft (CEA) took place in the 1980s[11]


, followed by the transplantation of


cultured composite skin substitutes in the 1990s[12]


. Research and development in the


fi eld have since progressed to include synthetic materials and genetic modifi cations. The fi rst


.


FUNCTION


Provides effi cient protection against mechanical disturbances, infection and hazardous substances Acts as a sensory organ Helps regulate temperature Prevents excessive fl uid loss and absorption Acts an immune organ to detect infections, etc Reduces harmful eff ects of UV radiation Helps in the production of vitamin D


Box 2 – The functions of the skin.


genetically modifi ed CEA for epidermolysis bullosa treatment was put to use in 2005[13]


References


6. Sheridan RL, Moreno C. Skin substitutes in burns. Burns 2001; 27: 92.


7. Shores JT, Gabriel A, Gupta S. Skin substitutes and alternatives: a review. Adv Skin Wound Care 2007; 20: 493–508.


8. Haynes B. The history of burn care. In: Bosivich J, (ed). The Art and Science of Burn Care. 1987; Aspen Rockville MD, USA: 3.


9. Piccola N. Use of frog skin as a temporary biologic dressing. Proc Am Burn Assoc 1992; 24.


.


TYPES OF SKIN INJURY The skin is the largest organ of the body and


10. Shores JT, Gabriel A, Gupta S. Skin substitutes and alternatives: A review. Adv Skin Wound Care 2007; 20: 9


11. O’Connor N, Mulliken JB, Banks- Schlegel S, Kehinde O, Green H. Grafting of burns with cultured epithelium prepared from autologous epidermal cells. Lancet 1981; 1: 75–8.


Figure 1 Examples of skin substitutes currently being used. Skin Substitutes


Synthetic SuprathelTM


Biosynthetic


Cultured Autograft


Biobrane®(Porcine) EZ-DermTM


Integra® (Bovine) Dermagraft® (Human) Epicel® (Porcine)


EpiDexTM MyskinTM ReCell®


Bioseed®-S CellSpray® StrataGraft®


Cultured skin substitute


Laserskin® VivodermTM


LyphodermTM ICX-SKN


AlloDerm® Biological Plant


Banana peel Potato skin


Allograft Cultured Amnion Cadaveric OrCel®


TransCyte® Apligraf®


OASIS®


Wound Matrix PermacolTM


Matriderm® + Xenograft Porcine Bovine


Frog Skin Lizard Skin


www.woundsinternational.com


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Technology and product reviews


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