Biomedical Engineering Reference
In-Depth Information
However, at present, no manufactured skin substitute has pro-
vided an outcome consistently comparable with an autologous skin
graft.Thereareproblemsthatshouldbesolvedwithcurrentlyavail-
able products, which are reduced vascularization, scarring, absence
of differentiated structures, delay involved with cell culture, per-
sistence of cells in heterologous grafts, biocompatibility, mechani-
cal and handling properties, cell source, and development, safety,
and product costs.
2
the clinical effect is often modest and some-
times not justifiable from a cost-benefit perspective. Nevertheless,
these devices continue to find application, and improvements may
facilitate broader use in the future. Skin replacement products are
the most advanced, with a number of tissue-engineered wound
care materials in several international communities. The potential
effect of this field is that it offers novel solutions to the medical
field for drug screening, genetic engineering, and tissue and organ
replacements.
39.4 Conclusions and Outlook
It is hoped that less expensive and more clinically effective tissue-
engineered skin products can be developed in the future. But, we
should keep in mind the fact that skin pathology is a multivari-
able process that cannot necessarily be solved with a construct that
histologically resembles the skin. A successful tissue-engineering
technique requires intensive cooperation between clinicians, biol-
ogists, and engineers. Tissue engineering and regenerative medi-
cine have given new therapeutic approaches that may overcome the
drawbacks in current therapies.
33
The importance of available first-
generation tissue-engineered products should not be discounted on
account of modest clinical and commercial success. Although these
products were not the success hoped for, an important proof-of-
principle was demonstrated in regulatory, technical, manufacturing,
logistical, and commercialization elements.
In the skin substitute field, a pathologic-based approach,
improvement in quality, and more clinical-oriented construction
will bring more similarity to native skin grafts. In this way, tissue-
engineered skin substitutes may be a therapeutic method for
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