Skin and Skin Substitutes in Wound Management

The development of bioengineered skin was motivated by the critical need to cover extensive burn injuries in patients with insufficient skin for grafting. Bioengineered skin substitutes have also been widely used for a variety of chronic wounds with the aim of faster healing, reduced infection and better cosmetic appearance.

Bioengineered skin consists of an outer epidermal layer and/or a dermal layer (the layer of skin between the epidermis and the subcutaneous tissue) embedded into an acellular matrix (a support structure) forming a biological skin substitute.

This ‘artificial’ tissue can be grown from the patient’s own cells or from another ‘allogeneic‘ (non-self) sources. Most commercial bioengineered skin consist of sheets of cells derived from neonatal (allogenic) foreskin. Neonatal foreskin is chosen because it is a convenient source obtained from healthy babies undergoing circumcision, it has a high content of epidermal keratinocyte stem cells, the cells grow vigorously with high metabolic activity, and allergic reactions against the cells are rare.

EpidermisBioengineered skin is designed to temporarily take over the functions of the epidermis and/or dermis until the patient’s skin barrier repairs spontaneously or until definitive skin replacement is possible with a skin graft or cultured equivalent. It is thought that bioengineered skin accelerates wound healing by introducing living cells to re-establish the conditions needed for repair including moist wound environment, structural support, cytokines and growth factors to stimulate immune response and tissue regeneration.

Globally, the market for bioenegineered skin and skin substitutes stands at just under $400 million and is growing at 14% annually. Active companies in this field include: LifeCell, Organogenesis, Celadon Science, Smith & Nephew, Genzyme Biosurgery, Brennen Medical, Integra LifeSciences, Fidia Advanced Biopolymers, Healthpoint, Ortec International, and Advanced Tissue Sciences, among others.

Skin substitutes, bioengineered skin and a wide range of other established and emerging products in wound management are the subject of the 2013 MedMarket Diligence Report #S249, “Wound Management, Worldwide Market and Forecast to 2021: Established and Emerging Products, Technologies and Markets in the Americas, Europe, Asia/Pacific and Rest of World.” (See link for full details.)

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