Skin Substitute Overview

Principles

Definition

Skin substitute is a research concept and field within biomedical science focused on the development, characterization, and clinical application of engineered biological, synthetic, or composite constructs designed to replace or augment damaged or missing skin tissue. It investigates strategies to provide wound coverage, promote tissue regeneration, and restore the structural and functional integrity of the skin, holding significant importance in burn treatment, chronic wound care, and reconstructive surgery.

Ontological type

Classification

Core Materials

Clinical Indications

Key developments

Key Figures

Living Cultured Grafts era

Thomas A. Mustoe [1] was affiliated with Harvard University [3] and Washington University in St. Louis [4] during the Living Cultured Grafts era. His key contributions include Accelerated Healing of Incisional Wounds in Rats Induced by Transforming Growth Factor-β [6] and Transforming growth factor beta reverses the glucocorticoid-induced wound-healing deficit in rats: possible regulation in macrophages by platelet-derived growth factor [7], advancing understanding of growth-factor–driven wound repair and informing strategies for integrating signaling into living grafts. H. Paul Ehrlich [2] was affiliated with Harvard University [3] and University of California, San Francisco [5] during this era. His key contribution is Living Tissue Formed in Vitro and Accepted as Skin-Equivalent Tissue of Full Thickness [8], which demonstrated that in vitro cultured living tissue could serve as a full-thickness skin substitute, laying foundational groundwork for the era’s cultured graft approaches.

Bilayer and Vascularized Constructs era

Louis C. Argenta [1] emerges as a key figure in skin substitute research during the Bilayer and Vascularized Constructs era, with affiliations at Wake Forest University [3] and Winston-Salem State University [4]. His pioneering work includes the Vacuum-Assisted Closure method [7], which addressed wound contraction and control and helped pave the way for integration with dermal cells and epidermal constructs in this era. Harold F. Dvorak [2] contributed foundational insights into angiogenic signals in wound healing, with affiliations at Harvard–MIT Division of Health Sciences and Technology [5] and Harvard University [6]. His Expression of vascular permeability factor (VEGF) by epidermal keratinocytes during wound healing [8] highlighted VEGF as a driver of vascularization, informing prevascularization strategies and the development of perfused, vascularized skin substitutes.

Biofabrication and Smart Dressings era

Peter M. Vogt [1], associated with University of Groningen [3] and Medizinische Hochschule Hannover [4] in this era of biofabrication and smart dressings, emerges as a key driver of laser-based skin fabrication. In this era, Vogt's key contributions include Tissue Engineered Skin Substitutes Created by Laser-Assisted Bioprinting Form Skin-Like Structures in the Dorsal Skin Fold Chamber in Mice [6] and Skin tissue generation by laser cell printing [7], which demonstrated precise in vivo organization of dermal–epidermal architectures and advanced functional skin substitute creation. Boris N. Chichkov [2], affiliated with Medizinische Hochschule Hannover [4] and North Carolina State University [5], also helped advance laser-assisted bioprinting in this era. His collaborative work on the same laser-assisted skin fabrication studies showcased the rapid construction of organized skin-like layers and highlighted pathways toward prevascularized, host-integrated substitutes, as seen in the papers [6][7].