Bioengineered skin constructs and their use in wound healing

Background: Over the past two decades, the field of wound healing and tissue repair has witnessed tremendous advances resulting from the biological sciences, biomedical and tissue engineering, and greater clinical understanding of wounds and their pathophysiology. In large part because of these advances, clinicians are now able to offer and deliver more sophisticated and effective treatments to patients with acute wounds, chronic wounds, burns, and other types of injuries. Methods: This report relies on published information focused on bioengineered skin and the authors' perspectives on the application of this technology in wound healing. In some cases, off-label applications of certain bioengineered skin constructs have been used to illustrate the spectrum of usefulness of these constructs. Results: Bioengineered skin (including acellular and cellular products; living and nonliving constructs; and epidermal, dermal, and bilayered therapeutic adjuncts) has resulted in very substantial and demonstrable improvements in wound care. Some of the constructs are U.S. Food and Drug Administration approved for treatment of burns and for impaired healing situations, including venous and diabetic foot ulcers. Conclusions: The advances that have occurred in testing and proving the efficacy of bioengineered skin hold great promise for further improvements in the way this technology is used in the surgical field and in wound care. Advances in therapeutic agents have also led to greater understanding of pathophysiology. Thus, wound bed preparation as a concept and as an approach is in fact the result of the need to maximize the benefits of advanced therapies.