Tissue-Engineered Skin Substitutes.

BACKGROUND: Skin substitutes are frequently used by plastic surgeons today to treat a wide variety of cutaneous defects. They provide methods to heal wounds while minimizing donor sites. They are commonly used in burns, acute wounds, and chronic wounds. METHODS: The authors reviewed the literature on both the development of skin substitutes and their use today. The authors focused their work on what are currently the more commonly used types of skin substitutes in the United States. There is a wide interest in human-derived placental products, which will be the subject of a future publication. RESULTS: Commonly used skin substitutes include semisynthetic dermal scaffolds, allogenic cell constructs, and cellular and decellularized allogenic or xenogenic sources. For semisynthetic dermal scaffolds and allogenic cell constructs, there have been large clinical trials demonstrating their efficacy. CONCLUSIONS: Skin substitutes represent great progress for plastic surgery and provide several advances and options with which to heal wounds. More studies are needed to guide surgeons into the most appropriate use of these materials. Future developments, including advances in scaffolds, stem cells, and tissue processing, are likely to produce even more clinical options for our patients.