A guide to biological skin substitutes.

The role of artificial skin substitutes in burn surgery and the treatment of chronic wounds is constantly evolving. New products are regularly being produced and approved for clinical use. Studies on existing products clarify their efficacy and effectiveness in different clinical scenarios. This review is aimed at busy clinicians in order to bring them up to date with the latest developments in the field of artificial skin substitutes. It examines the components, structure, performance and comparative costs of the main commercial skin substitutes, and reviews briefly technologies under development that have not yet become widely available.

[1]  JOHN F. BURKE,et al.  Successful Use of a Physiologically Acceptable Artificial Skin in the Treatment of Extensive Burn Injury , 1981, Annals of surgery.

[2]  W. Hickerson,et al.  Acceleration of skin regeneration from cultured epithelial autografts by transplantation to homograft dermis. , 1993, The Journal of burn care & rehabilitation.

[3]  Y. Barrandon,et al.  LONG-TERM REGENERATION OF HUMAN EPIDERMIS ON THIRD DEGREE BURNS TRANSPLANTED WITH AUTOLOGOUS CULTURED EPITHELIUM GROWN ON A FIBRIN MATRIX1,2 , 2000, Transplantation.

[4]  I. Leigh,et al.  Treatment of chronic venous ulcers with sheets of cultured allogenic keratinocytes , 1987, The British journal of dermatology.

[5]  C. Compton,et al.  Permanent Coverage of Large Burn Wounds with Autologous Cultured Human Epithelium , 1984 .

[6]  I. Yannas,et al.  Design of an artificial skin. II. Control of chemical composition. , 1980, Journal of biomedical materials research.

[7]  R. Dover,et al.  Survival of allogeneic cells in cultured organotypic skin grafts. , 1995, Plastic and reconstructive surgery.

[8]  M. Pierschbacher,et al.  Enhancement of cell interactions with collagen/glycosaminoglycan matrices by RGD derivatization. , 1997, Biomaterials.

[9]  M. M. Ghosh,et al.  A Comparison of Methodologies for the Preparation of Human Epidermal‐Dermal Composites , 1997, Annals of plastic surgery.

[10]  L. Bruckner-Tuderman,et al.  Epithelial-mesenchymal interactions enhance expression of collagen VII in vitro. , 1990, The Journal of investigative dermatology.

[11]  B. Latenser,et al.  The use of a permanent dermal allograft in full-thickness burns of the hand and foot: a report of three cases. , 1997, The Journal of burn care & rehabilitation.

[12]  R Cancedda,et al.  Multicentre experience in the treatment of burns with autologous and allogenic cultured epithelium, fresh or preserved in a frozen state. , 1989, Burns : journal of the International Society for Burn Injuries.

[13]  M. Auletta,et al.  Cultured skin as a 'smart material' for healing wounds: experience in venous ulcers. , 1996, Biomaterials.

[14]  S. Boyce,et al.  Burn wound closure with cultured autologous keratinocytes and fibroblasts attached to a collagen-glycosaminoglycan substrate. , 1989, JAMA.

[15]  M. Robson,et al.  DRG-driven change in burn wound management: a success story. , 1988, Plastic and reconstructive surgery.

[16]  R. Bartlett,et al.  A new composite skin prosthesis , 1980 .

[17]  N. Isshiki,et al.  A bilayer "artificial skin" capable of sustained release of an antibiotic. , 1991, British journal of plastic surgery.

[18]  J. Hansbrough,et al.  Current trends in the use of allograft skin for patients with burns and reflections on the future of skin banking in the United States. , 1994, The Journal of burn care & rehabilitation.

[19]  R. Sheridan,et al.  Artificial skin in massive burns — results to ten years , 1994, European Journal of Plastic Surgery.

[20]  R. Spielvogel.  A histological study of Dermagraft-TC in patients' burn wounds. , 1997, The Journal of burn care & rehabilitation.

[21]  E. Engleman,et al.  Cultured human epidermal cells do not synthesize HLA-DR. , 1982, The Journal of investigative dermatology.

[22]  C. Compton,et al.  Skin regenerated from cultured epithelial autografts on full-thickness burn wounds from 6 days to 5 years after grafting. A light, electron microscopic and immunohistochemical study. , 1989, Laboratory investigation; a journal of technical methods and pathology.

[23]  P. Lam,et al.  A new technique to resurface wounds with composite biocompatible epidermal graft and artificial skin. , 2001, The Journal of trauma.

[24]  B. Gilchrest,et al.  Cultured epidermal allografts as biological wound dressings. , 1991, Progress in clinical and biological research.

[25]  I. Silver,et al.  Growth regulation of skin cells by epidermal cell-derived factors: implications for wound healing. , 1988, Proceedings of the National Academy of Sciences of the United States of America.

[26]  J. Hansbrough,et al.  Development of a temporary living skin replacement composed of human neonatal fibroblasts cultured in Biobrane, a synthetic dressing material. , 1994, Surgery.

[27]  M. Nave.  Wound bed preparation: approaches to replacement of dermis. , 1992, The Journal of burn care & rehabilitation.

[28]  R. Odessey,et al.  Addendum: multicenter experience with cultured epidermal autograft for treatment of burns. , 1992, The Journal of burn care & rehabilitation.

[29]  Edwin H. Greenebaum.  Clinical Experience , 2017 .

[30]  R. Demling,et al.  Management of partial thickness facial burns (comparison of topical antibiotics and bio-engineered skin substitutes). , 1999, Burns : journal of the International Society for Burn Injuries.

[31]  S. Boyce,et al.  Biologic attachment, growth, and differentiation of cultured human epidermal keratinocytes on a graftable collagen and chondroitin-6-sulfate substrate. , 1988, Surgery.

[32]  R. Martin,et al.  Retroviral marking identifies grafted autologous keratinocytes in porcine wounds receiving cultured epithelium. , 1997, The Journal of investigative dermatology.

[33]  H. D. Peterson,et al.  Burn wounds resurfaced by cultured epidermal autografts show abnormal reconstitution of anchoring fibrils. , 1988, JAMA.

[34]  A. Lin,et al.  Treatment of junctional epidermolysis bullosa with epidermal autografts. , 1987, Journal of the American Academy of Dermatology.

[35]  J. Hansbrough,et al.  Enteral nutritional support and wound excision and closure do not prevent postburn hypermetabolism as measured by continuous metabolic monitoring. , 2000, The Journal of trauma.

[36]  B. Woodward,et al.  The use of cultured autologous keratinocytes with integra in the resurfacing of acute burns. , 1998, Plastic and reconstructive surgery.

[37]  S. Boyce,et al.  The 1999 clinical research award. Cultured skin substitutes combined with Integra Artificial Skin to replace native skin autograft and allograft for the closure of excised full-thickness burns. , 1999, The Journal of burn care & rehabilitation.

[38]  I. Yannas,et al.  Design of an artificial skin. I. Basic design principles. , 1980, Journal of biomedical materials research.

[39]  B. Gilchrest,et al.  Cultured epidermal autografts and allografts: a study of differentiation and allograft survival. , 1990, Journal of the American Academy of Dermatology.

[40]  M L Cooper,et al.  In vivo optimization of a living dermal substitute employing cultured human fibroblasts on a biodegradable polyglycolic acid or polyglactin mesh. , 1991, Biomaterials.

[41]  N. Gibran,et al.  Effect of storage and preservation methods on viability in transplantable human skin allografts. , 2000, Burns : journal of the International Society for Burn Injuries.

[42]  G. Spilker,et al.  Cultured autologous keratinocytes in fibrin glue suspension, exclusively and combined with STS-allograft (preliminary clinical and histological report of a new technique). , 1994, Burns : journal of the International Society for Burn Injuries.

[43]  A. Demidem,et al.  Long-term survival and immunological tolerance of human epidermal allografts produced in culture. , 1986, Transplantation.

[44]  C. Kirkpatrick,et al.  Treatment of skin defects using suspensions of in vitro cultured keratinocytes. , 1994, Burns : journal of the International Society for Burn Injuries.

[45]  H Green,et al.  Growth of cultured human epidermal cells into multiple epithelia suitable for grafting. , 1979, Proceedings of the National Academy of Sciences of the United States of America.

[46]  W. Eaglstein,et al.  A Composite Skin Substitute (Graftskin) for Surgical Wounds: A Clinical Experience , 1995, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[47]  A. Zicca,et al.  Histological evaluation of human cultured epithelium before and after grafting. , 1992, Burns : journal of the International Society for Burn Injuries.

[48]  J. Hansbrough,et al.  Clinical trials of a living dermal tissue replacement placed beneath meshed, split-thickness skin grafts on excised burn wounds. , 1992, The Journal of burn care & rehabilitation.

[49]  J. Hansbrough,et al.  Clinical trials of a biosynthetic temporary skin replacement, Dermagraft-Transitional Covering, compared with cryopreserved human cadaver skin for temporary coverage of excised burn wounds. , 1997, The Journal of burn care & rehabilitation.

[50]  M. Sabolinski,et al.  The effect of a tissue engineered bilayered living skin analog, over meshed split-thickness autografts on the healing of excised burn wounds. The Apligraf Burn Study Group. , 2000, Burns : journal of the International Society for Burn Injuries.

[51]  M. Longaker,et al.  Histologic study of artificial skin used in the treatment of full-thickness thermal injury. , 1990, The Journal of burn care & rehabilitation.

[52]  A. Dobozy,et al.  Keratinocyte grafting: a new means of transplantation for full-thickness wounds. , 1988, The Journal of dermatologic surgery and oncology.

[53]  J. Davies.  Synthetic materials for covering burn wounds: progress towards perfection. Part II. Longer term substitutes for skin. , 1983, Burns, including thermal injury.

[54]  Edward Y Lee,et al.  Synthesis and characterization of a model extracellular matrix that induces partial regeneration of adult mammalian skin. , 1989, Proceedings of the National Academy of Sciences of the United States of America.

[55]  I. Leigh,et al.  A porcine model using skin graft chambers for studies on cultured keratinocytes. , 1993, British journal of plastic surgery.

[56]  B. Pruitt,et al.  Characteristics and uses of biologic dressings and skin substitutes. , 1984, Archives of surgery.

[57]  R. Martin,et al.  The co-application of sprayed cultured autologous keratinocytes and autologous fibrin sealant in a porcine wound model. , 2002, British journal of plastic surgery.

[58]  Cost-effectiveness modeling of Dermagraft for the treatment of diabetic foot ulcers in the french context. , 2000, Diabetes & metabolism.

[59]  V. Gielen,et al.  Progressive replacement of human cultured epithelial allografts by recipient cells as evidenced by HLA class I antigens expression. , 1987, Dermatologica.

[60]  L. Germain,et al.  ALLOGENEIC‐SYNGENEIC CULTURED EPITHELIA: A SUCCESSFUL THERAPEUTIC OPTION FOR SKIN REGENERATION , 1995, Transplantation.

[61]  S. Boyce,et al.  Study of HLA-DR synthesis in cultured human keratinocytes. , 1986, The Journal of investigative dermatology.

[62]  D. Herndon.  Total Burn Care , 1996 .

[63]  C C Compton,et al.  Vascularized Collagen‐Glycosaminoglycan Matrix Provides a Dermal Substrate and Improves Take of Cultured Epithelial Autografts , 1998, Plastic and reconstructive surgery.

[64]  J. Hunt,et al.  Clinical evaluation of an acellular allograft dermal matrix in full-thickness burns. , 1996, The Journal of burn care & rehabilitation.

[65]  M L Cooper,et al.  Evaluation of a biodegradable matrix containing cultured human fibroblasts as a dermal replacement beneath meshed skin grafts on athymic mice. , 1992, Surgery.

[66]  H. Green,et al.  Seria cultivation of strains of human epidemal keratinocytes: the formation keratinizin colonies from single cell is , 1975, Cell.

[67]  I. Leigh,et al.  Survival of cultured allogeneic keratinocytes transplanted to deep dermal bed assessed with probe specific for Y chromosome. , 1989, BMJ.

[68]  I. Leigh,et al.  An animal model to study the significance of dermis for grafting cultured keratinocytes on full thickness wounds. , 1994, Burns : journal of the International Society for Burn Injuries.

[69]  C. Compton,et al.  Cultured Epithelial Autografts for Giant Congenital Nevi , 1989, Plastic and reconstructive surgery.

[70]  H. Carsin,et al.  Cultured epithelial autografts in extensive burn coverage of severely traumatized patients: a five year single-center experience with 30 patients. , 2000, Burns : journal of the International Society for Burn Injuries.

[71]  K. Newman,et al.  The use of a bioactive skin substitute decreases length of stay for pediatric burn patients. , 2001, Journal of pediatric surgery.

[72]  R. Dover,et al.  CULTURED COMPOSITE SKIN GRAFTS: BIOLOGICAL SKIN EQUIVALENTS PERMITTING MASSIVE EXPANSION , 1989, The Lancet.

[73]  S. Mac Neil,et al.  Development of autologous human dermal–epidermal composites based on sterilized human allodermis for clinical use , 1999, The British journal of dermatology.

[74]  D. Margolis,et al.  Rapid healing of venous ulcers and lack of clinical rejection with an allogeneic cultured human skin equivalent. Human Skin Equivalent Investigators Group. , 1998, Archives of dermatology.

[75]  D. Heimbach,et al.  Artificial Dermis for Major Burns: A Multi‐Center Randomized Clinical Trial , 1988, Annals of surgery.

[76]  F. A. Navarro,et al.  Sprayed keratinocyte suspensions accelerate epidermal coverage in a porcine microwound model. , 2000, The Journal of burn care & rehabilitation.

[77]  J. Hansbrough.  Dermagraft-TC for partial-thickness burns: a clinical evaluation. , 1997, The Journal of burn care & rehabilitation.

[78]  G. Naughton,et al.  A metabolically active human dermal replacement for the treatment of diabetic foot ulcers. , 2008, Artificial organs.

[79]  Huang Shu-zhen,et al.  Clinical observations and methods for identifying the existence of cultured epidermal allografts. , 1992 .

[80]  H. Broly,et al.  Use of human keratinocytes cultured on fibrin glue in the treatment of burn wounds. , 1991, Burns : journal of the International Society for Burn Injuries.

[81]  L D Solem,et al.  A multicenter clinical trial of a biosynthetic skin replacement, Dermagraft-TC, compared with cryopreserved human cadaver skin for temporary coverage of excised burn wounds. , 1997, The Journal of burn care & rehabilitation.

[82]  A. Andreassi,et al.  A new model of epidermal culture for the surgical treatment of vitiligo , 1998, International journal of dermatology.

[83]  V. Falanga.  Tissue engineering in wound repair. , 2000, Advances in skin & wound care.

[84]  J. Hunt,et al.  Biosynthetic skin substitute versus frozen human cadaver allograft for temporary coverage of excised burn wounds. , 1987, The Journal of trauma.

[85]  L. Argenta,et al.  Scalp necrosis in a neonate treated with cultured autologous keratinocytes. , 1991, Plastic and reconstructive surgery.

[86]  B. K. Siwy,et al.  Cultured epidermis: Indiana University Medical Center's experience. , 1992, The Journal of burn care & rehabilitation.

[87]  P. Lam,et al.  Development and evaluation of a new composite Laserskin graft. , 1999, The Journal of trauma.