Technology update Advances in tissue-engineered skin substitutes


Integra® Integra LifeSciences Corporation, Plainsboro, NJ, USA


Biobrane® UDL Laboratories Inc, Rockford, IL, USA


Matriderm® Dr. Suwelack Skin & Health Care AG, Billerbeck, Germany


Permacol™ Covidien plc, Dublin, Ireland


OASIS® Wound Matrix Healthpoint Ltd, Fort Worth, TX, USA


TransCyte® Advanced Biohealing Inc, La Jolla, CA, USA


Two-layered skin substitute comprising bovine collagen and an outer silicone layer


Porcine dermal collagen bonded to semipermeable silicone membrane


Bovine dermal collagen and elastin


Processed dermal xenograft


Immediate permanent coverage for surgically excised deep or full-thickness burns; as a reconstructive replacement in plastic surgery


To cover partial thickness burns and skin graft donor sites


Burns and reconstruction, non- healing wounds that require skin grafts, such as diabetic foot ulcers


Temporary coverage in partial- thickness burn, complex hernias and abdominal wall repair


Processed dermal xenograft


Partial/full-thickness wounds, diabetic, venous, pressure and chronic vascular ulcers, trauma wounds (including burns), surgical and drainage wounds


Allogenic human fibroblasts cultured on nylon mesh, coated with porcine collagen and neonatal foreskin fibroblasts


Dermagraft® Advanced Biohealing Inc, La Jolla, CA, USA


ICX-SKN Intercytex Ltd, Alderley Edge, UK


Apligraf® Organogenesis Inc, Canton, MA, USA


OrCel® Forticell Biosciences Inc, Englewood Cliffs, NJ, USA


Cultured Skin Substitute University of Cincinnati, USA


StrataGraft® Stratatech Corporation, Madison, WI, USA


Allogenic human fibroblasts cultured on bioabsorbable scaffold


Cultured dermal allograft


To temporarily cover surgically excised full-thickness and deep partial-thickness burns before autograft placement


Full-thickness diabetic foot ulcers


To cover surgically excised partial thickness burns


Cultured allogenic skin containing neonatal keratinocytes and fibroblasts


Cultured allogenic skin containing neonatal keratinocytes, fibroblasts and bovine collagen


Cultured composite autograft


Non-healing diabetic foot ulcers and venous leg ulcers


Treatment of acute and chronic deep dermal ulcers, partial- thickness burns and donor site wounds


Permanent wound closure in large area burns and other congenital skin disorders


Cultured composite autograft (using NIKS® cells)


Treatment of partial-thickness burns and severe skin wounds


Requires healthy and non- infected wound base Autograft is needed for epithelial cover


Temporary Not suitable for infected wounds


Autograft is needed for epithelial cover Not suitable for infected wounds


Not suitable for infected wounds


Not suitable for infected wounds


Autograft is needed for epithelial cover Temporary (may need skin grafting after 2-3 weeks) Not suitable for infected wounds


Not suitable for infected wounds or ulcers with sinus tracts


In burns, autograft is needed for epithelial cover Not suitable for infected wounds


Not suitable for infected wounds or patients allergic to bovine collagen


Not suitable for infected wounds or patients allergic to bovine collagen


Not suitable for infected wounds


2-3 week lag period between biopsy and obtaining epidermis Temporary coverage before autografting Not suitable for infected wounds


Table 1 – Examples of some commercially available skin substitutes. References


36. Larochelle F, Ross G, Rouabhia M. Permanent skin replacement using engineered epidermis containing fewer than 5% syngeneic keratinocytes. Lab Invest 1998; 78: 1089–1099.


37. Rouabhia M. Permanent skin replacement using chimeric epithelial cultured sheets comprising xenogeneic and syngeneic keratinocytes. Transplant 1996; 61: 1290–1300.


38. Supp DM, Supp AP, Bell SM et al. Enhanced vascularization of cultured skin substitutes genetically modified to overexpress vascular endothelial growth factor. J Invest Dermatol 2000; 114: 5–13.


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