Skin Substitutes

Skin Substitutes

For many severely burned patients skin grafts using their own healthy skin is not possible because they have very little healthy skin or they are not strong enough for surgery. The other alternatives to cover burn wounds is to use cadaver skins or animal skin. The body will reject both of these options within a few days and the surgery will need to be performed again. For years healthcare professionals working in burn units have hoped for the day that they could pull substitute skin off a shelf, that day has finally come. In 1997, a new synthetic product called Dermagraft-TC became available to doctors and patients. Dermagraft-TC is made from living human cells and it is being used instead of cadaver skin.

The FDA approved Dermagraft-TC and two artificial “interactive” burn dressings for use in treating third-degree burns. They are Integra Artificial Skin and Original BioBrane. Unlike traditional bandages, some new dressings promote wound healing by interacting directly with body tissues.

BioBrane is a nylon material that contains a gelatin that interacts with clotting factors in the wound. That interaction causes the dressing to adhere better, forming a more durable protective layer.

Integra is a two-layered dressing. The top layer serves as a temporary synthetic epidermis; the layer below serves as a foundation for re-growth of dermal tissue. The underlying layer is made of collagen fibers that act as a lattice through which the body can begin to align cells to recreate its own dermal tissue.

Other substitute skin products may become available soon. Organogenesis Inc. is selling its Apilgra, a living “human skin equivalent” to treat wounds and ulcers in Canada and the company is seeking approval for sales in the U.S. Additionally, LifeCell Corporation makes implantable human tissue for use in reconstructive surgery and burn treatment.

In addition to artificial skins is cultured skin. Doctors are able to take a postage stamp-sized piece of skin from the patient and grow the skin under special tissue culture conditions. From this small piece of skin, technicians can grow enough skin to cover nearly the entire body in just 3 weeks. Cultured skin has been available in the U.S. for a decade.

Artificial skins are only a temporary fix; the patient will still need skin grafts. However, with the use of artificial skins means a thinner skin graft, which allows the donor site and the patient to heal faster with fewer surgeries.

The use of artificial skins has not yet been perfected and they are not right for every burn patient. Additionally scarring still results, but it may be less severe.