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Review
. 2015 Jul 9;6(3):547-63.
doi: 10.3390/jfb6030547.

Advances in Skin Substitutes-Potential of Tissue Engineered Skin for Facilitating Anti-Fibrotic Healing

Mathew Varkey  1 , Jie Ding  2 , Edward E Tredget  3   4
Affiliations
Review

Advances in Skin Substitutes-Potential of Tissue Engineered Skin for Facilitating Anti-Fibrotic Healing

Mathew Varkey et al. J Funct Biomater. .

Abstract

Skin protects the body from exogenous substances and functions as a barrier to fluid loss and trauma. The skin comprises of epidermal, dermal and hypodermal layers, which mainly contain keratinocytes, fibroblasts and adipocytes, respectively, typically embedded on extracellular matrix made up of glycosaminoglycans and fibrous proteins. When the integrity of skin is compromised due to injury as in burns the coverage of skin has to be restored to facilitate repair and regeneration. Skin substitutes are preferred for wound coverage when the loss of skin is extensive especially in the case of second or third degree burns. Different kinds of skin substitutes with different features are commercially available; they can be classified into acellular skin substitutes, those with cultured epidermal cells and no dermal components, those with only dermal components, and tissue engineered substitutes that contain both epidermal and dermal components. Typically, adult wounds heal by fibrosis. Most organs are affected by fibrosis, with chronic fibrotic diseases estimated to be a leading cause of morbidity and mortality. In the skin, fibroproliferative disorders such as hypertrophic scars and keloid formation cause cosmetic and functional problems. Dermal fibroblasts are understood to be heterogeneous; this may have implications on post-burn wound healing since studies have shown that superficial and deep dermal fibroblasts are anti-fibrotic and pro-fibrotic, respectively. Selective use of superficial dermal fibroblasts rather than the conventional heterogeneous dermal fibroblasts may prove beneficial for post-burn wound healing.

Keywords: fibrosis; skin substitutes; tissue engineering; wound healing.

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Figures

Figure 1
Figure 1
Structure of human skin showing dermal heterogeneity. Epidermis, basement membrane (BM) superficial dermis, rete pappillare, deep dermis and rete cutaneum. SF: superficial fibroblasts, DF: deep fibroblasts, HF: hair follicle are indicated. Modified from [15].
Figure 2
Figure 2
Dermal Fibroblast heterogeneity and their different roles in ECM remodelling. Superficial dermal fibroblasts negatively regulate fibrosis and have higher expression of anti-fibrotic genes, whereas deep dermal fibroblasts are promote fibrosis and have higher expression of pro-fibrotic genes.
See this image and copyright information in PMC

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