Bio-Engineered Skin Grafts & Substitutes
What Are Bio-Engineered Skin Grafts/Substitutes?
Bioengineered skin grafts or substitutes – a.k.a artificial skin, living skin equivalents, tissue- engineered skin substitutes, human skin equivalents, or skin alternatives – may be indicated when the patient has a limited amount of usable skin or is too ill to tolerate the creation of additional wound sites. These treatments are commonly used to heal chronic wounds, severe burns, and rare skin conditions such as recessive dystrophic epidermolysis bullosa. They are also a viable alternative to skin grafting for those with conditions that include diabetic foot ulcers, acute surgical wounds, leg ulcers, and lower extremity ulcers.
The composition of bioengineered skin may include a dermal (inner) layer, an epidermal (outer) layer, or a combination thereof, embedded within a cellular or acellular support structure (matrix). Acellular matrices contain no living cells, but are instead comprised of materials such as collagen, fibronectin, and hyaluronic acid. Cellular matrices contain living cells obtained from humans (patient or other donor) or another species.
Bioengineered skin can be created using these substances:
- Autologous Human Tissue: Originating from the patient’s own cells
- Allogeneic Human Tissue: These products come from a human other than the patient. A common practice is using cells taken from neonatal foreskin (skin obtained from newborn babies during circumcision).
- Xenographic Non-Human Tissue: Originating from non-human species such as cows, pigs, and horses
- Synthetic Materials: A laboratory-produced product created from manmade materials such as polymers, silicone, and collagen
- Composite: Originating from any mixture of materials listed above
Bioengineered skin can be used as a temporary or permanent wound covering. It helps promote new skin growth and stimulates wound healing by introducing living cells that re-establish a moist wound environment and structural support. In addition to benefits that include treatment cost reductions and shorter hospital stays, bioengineered skin grafts are readily available, affordable, and biodegradable.
Since many companies market bioengineered skin substitutes, it’s essential to understand the similarities and differences, along with the fact each product requires approval from the US Food and Drug Administration (FDA) for specific indications.