ARTIFICIALSKINMaierdanjiangWufuer買爾旦江吾甫爾DepartmentofPlasticandReconstructiveSurgery,InstituteofHuman-EnvironmentInterfaceBiology,CollegeofMedicine,SeoulNat’lUniversity,Seoul,RepublicofKoreaBiomedicalResearchInstitute,SeoulNat’lUniv.Hospital,Seoul,RepublicofKoreaApligraf?CountryObjectiveEpidermisDermis/Matrix

graft?FDA&IndicationstoragUSA,Organogenesis,Inc.Epidermal/DermalreplacementKeratinocytes

fromhumanneonatalforeskintissueBovinecollagenIgelwithallogeneicNOFDA1998,approvedforuseinthetreatmentofdiabeticfootulcersandvenouslegulcers.37'incubator,viablefor2-3daysdifferentiationApplicationAdvantagesDisadvantagesPriceMoreinfoReference10days1.Preparewound2.Applyapligraf3.DresswoundWounddressingwithtwodifferentcelltypes,3timesfasterhealingindifficultwounds/Mostexpensive,shortshelf-life$1,100./42cm2abilaminarstructureformedbytype

Ibovinecollagengelpopulatedbyliveneonatal

fibroblastscoatedwithalayerofepithelialcellsWilkinsLM,WatsonSR,ProskySJ,etal.Developmentofabilayeredlivingskinconstructforclinicalapplications.BiotechnolBioeng.1994;43747-756.2.ParenteauNL,NolteCM,BilboP,etal.Epidermisgeneratedinvitro:practicalconsiderationsandapplications.JCellBiochem.1991;45:245-251OrCel?CountryObjectiveEpidermisDermis/Matrix

STG?FDA&IndicationstoragUSA,ForticellBioscienceInc.,NYEpidermal/dermalreplacementkeratinocytesderivedfromneonatalforeskin,Bovinecollagenspongewithallogeneicfibroblastsandkeratinocytes）no2001,FDAapprove,partial-thicknesswounds37'incubatordifferentiationApplicationAdvantagesDisadvantagesPriceMoreinfoReference37'incubator1.Preparewound2.Applyorcel3.Dresswoundwhereitprovidesafavourablematrixforhostcellmigration.expensive$1,200/44cm2OrCel?

isabilayerdressingresemblingnormalskinandwasdevelopedasatissue-engineeredbiologicaldressing./orcel-technology/Integra?CountryObjectiveEpidermisDermis/Matrix

SG?FDA&IndicationstoragUSA,IntegraLifeSciencesCorp.,NJ,Dermalreplacementsilicone/Syntheticpolysiloxanepolymer/thatactsskinepidermis.Itprotectsthewoundfrominfectionandcontrolsbothheatandmoistureloss.Thedermallayerismadeofa3Dporousmatrixofcross-linkedcollagen(purecollagenfromcows)andglycosaminoglycan.(glycosaminoglycanmadefromsharkcartilage).yesFDAIn1996,treatmentoflifethreateningburinjuriesand2014thereconstructionofscarcontractures.EachsheetofIntegratemplateisstoredin

phosphatebufferwithinafoilpouch.Eachsterilefoilpouchispackagedinasealedouterchevron-style

pouch.

flatat2°–30°C.Protectfromfreezing.differentiationApplicationAdvantagesDisadvantagesPriceMoreinfoReferenceNO1.Day21+:SiliconeRemoval2.Day21+:epidermalautograftHasthesomeoftheadvantagesofanautograftwithoutadonorsite.Oncethesiliconesheetbeginstoseparatewithvascularizationofthecollagenmatrix,itisremovedandengineeredtissueplacedoverthisbed

orSTSGusedIntheabsenceoflivingcells,itisverydifficulttoseehowonecouldcreateapermanentartificialdermalbarrier.

isabi-layered

extracellularmatrixoffibersofcross-linkedbovinecollagenandchondroitin-6-sulfate(acomponentof

cartilage)withsiliconebacking.Onceanorganizedregenerationofdermaltissueisformed(neodermis),thedisposablesiliconesheetisremovedandanultrathinautograftisplacedovertheneodermis.1.-

I.V.Yannas;"Designofanarti?cialskinII:Controlofchemicalcomposition."Dermagraft?CountryObjectiveEpidermisDermis/Matrix

graft?FDA&IndicationstoragUSA,OrganogenesisInc.,MADermalreplacementNOlivingallogeneicfibroblastsonapolyglactinmesh.YESFDA-approvedfordiabeticulcers,treatdeeperwounds.

Inabox/pouch.Preservedat-70°Cwith6-monthshelf-lifedifferentiationApplicationAdvantagesDisadvantagesPriceMoreinfoReferenceno1.Preparewound2.Apply3.Dresswound.Thepolyglactinmeshisbiodegradableandisreabsorbedafter

3to4weeks.includealackofhostimmuneresponse,easeof

applicationandresistancetotearingAsDermagrafthasnoepidermalcomponent,clinicianshaveuseditwithasubsequentapplicationofasplitthicknessskingraft.2*3CM,$1500perapplicationThefibroblastscomefromneonatalforeskinandremainviableafterimplantation,continuingtosecretematrixproteinsandgrowthfactors./home/Epicel?CountryObjectiveEpidermisDermis/Matrix

graft?FDA&IndicationstoragUSA,GenzymeCorporation,CambridgeMA,EpidermalcoverCulturedsubstitute:autologouskeratinocyteswithmurinefibroblastsN0NOsuperficialwounds.

37'incubatordifferentiationApplicationAdvantagesDisadvantagesPriceMoreinfoReferenceTheproductismadefromabiopsyofthepatient’sownskin,whichissubsequentlyculturedforthreeweeks.Epicel?consistsofsheetsofautologouskeratinocytesattachedtoapetrolatumgauzesupport,whichisremovedapproximately1weekaftergraftingTheabilitytoexpandepidermalcellsinvitroandproduceautologousculturedepitheliumwasanimportantbreakthroughinburntherapyincludecostanddelayofapplicationduetothethree-weekgraftcultivation.Ithasnodermalcomponentandisaccordinglysuitedformoresuperficialwounds.

Thepatient’sownskincellsare

grownorculturedfromapostage‐stampsizedsampleofthepatient’sownhealthyskin.Theskincells

aregrownonalayerofirradiatedmousecells,makingEpicel?axenotransplantationproduct.TransCyte?CountryObjectiveEpidermisDermis/Matrix

graft?FDA&IndicationstoragUSADermalreplacementOuterepidermalanalogisathinnonporoussiliconemesh-likematerialwithbarrierfunctionsInnerdermalanalogislayeredwithhumanfibroblastproductsmainlycollagentype1,fibronectinandGlycosaminoglycanYESItistypicallyusedtotreatseconddegreeburnfrozendifferentiationApplicationAdvantagesDisadvantagesPriceMoreinfoReferenceHumanFibroblastDerivedTemporarySkinSubstituteTemporarywoundcoveringforsurgicallyexcisedfullthicknessandpartialthicknessburns.Thiscryopreservedmatrixcontainshighlevelsofproteinsandgrowthfactorswithnoviablecells.NeedtostorefrozentilluseRelativelyexpensiverequirementofmultipleapplications

HumanFibroblastDerivedTemporarySkinSubstitute

Temporarywoundcoveringforsurgicallyexcisedfullthicknessandpartialthicknessburns.

anoutersiliconelayer(withnopores)Alloderm?CountryObjectiveEpidermisDermis/Matrix

graft?FDA&IndicationstoragUSA,LifeCellCorporation,Bridgewater,NJDermalreplacementNONon-livingdermalreplacementcomposedofhumancadavericskininwhichtheepidermishasbeenremovedbysaltprocessing.

yesbothacuteandchronicwounds.freeze-drieddifferentiationApplicationAdvantagesDisadvantagesPriceMoreinfoReferenceNO1.Preparewound2.Apply3.Dresswound.ofAllodermincludealongshelflifebecauseitisfreezedried,

immediateavailabilityandminimalriskforhostimmunologicresponse.ofthisproductincludetheriskofdiseasetransmission.

Thereisnoepidermalcomponentso

clinicianscommonlyusetheproductwithasplit-thicknessskingraft.AlloDermsupportstissueregenerationbyallowingrapidrevascularization,whitecellmigrationandcellpopulation-ultimatelybeingtransformedintohosttissueforastrong,naturalrepair./alloderm.aspxOasis?CountryObjectiveEpidermisDermis/Matrix

graft?FDA&IndicationstoragUSA,

CookBiotech,Inc.DermalreplacementNOintactmatrixnaturallyderivedfromporcinesmallintestinalsubmucosa(SIS),YESpartial-andfull-thicknesswounds,pressureulcers,venousulcers,chronicvascularulcers,Roomtemperatureandon-the-shelfstorage/Long2-yearshelflifedifferentiationApplicationAdvantagesDisadvantagesPriceMoreinfoReferencePrepareApplyAnchorRehydrate5.Dress6.Cover7.Reassess8.Reapplyevery7daysReapplyOASIS?WoundMatrixevery7daysorasneeded,Ifagelformsonthewoundsurface,donotattempttoforciblyremove.Gentlyrinsethewoundsurface,leavingtheextracellularmatrix(ECM)gelintact.Long2-yearshelflife

Minimallyprocessedandsterilizedusingaproprietarymethodthatallowslong-termstorageofthestructurewithoutcompromisingitsabilitytosupportthebody’sowntissuerepairmechanisms2/application-wound-matrixMatriderm?CountryObjectiveEpidermisDermis/Matrix

graft?FDA&IndicationstoragGermany,MedSkinSolutionsDr.SuwelackAG,BillerbeckDermalreplacementNOmatrixcontainingI,II,andV-typecollagenextractedfrombovineligamentanddermis,andalpha-elastinhydrolysates.IYESacuteburnwoundsandscarreconstructionprocedures.RoomtemperaturedifferentiationApplicationAdvantagesDisadvantagesPriceMoreinfoReferenceItcanbeappliedconcurrentlywiththesplit-thicknessskingraftItcanbeappliedconcurrentlywiththesplit-thicknessskingraftappliedtogetherwithasplitskingraf,,secondarysurgeryisnotrequiredThematrixservesasasupportstructurefortheingrowthofcellsandvessels.

Biobrane?CountryObjectiveEpidermisDermis/Matrix

graft?FDA&IndicationstoragUSADermalreplacementOuterepidermalanalog—ultrathinsiliconefilm;innerdermalanalog—3DnylonfilamentwithtypeIcollagenpeptidesYESThetreatmentisspecifictononinfectedpartial-thicknessburnwoundsanddonorsitewounds,RTdifferentiationApplicationAdvantagesDisadvantagesPriceMoreinfoReferenceBiobraneisappliedandheldinplacewithspecialglue.Biobranewilltakebetween10-14days.BiobranehasbeenshowntoreducethepainanddiscomfortfeltwhentheskinisscaledTemporarywounddressingthatisremovedwhenwoundishealedorwhenautograftskinisavailableBiobrane?wasfirstintroducedforthetreatmentofburnwoundsanddonorsitesin197911.SmithDJ.UseofBiobraneinwoundmanagement.JBCRMay/June1995:16(3)Supplement;317-320.Theraskin?CountryObjectiveEpidermisDermis/Matrix

graft?FDA&IndicationstoragUSAEpidermal/dermalreplacementhumanskinallograft,composedoflivingcells,keratinocyteshumanskinallograft,fibroblastsandafullydevelopedextracellularmatrix(ECM)initsepidermisanddermislayers.NOnon-healingchronicwoundTheraSkiniscryopreserved(-70oC)differentiationApplicationAdvantagesDisadvantagesPriceMoreinfoReferenceLandsman,A.(2010).Aretrospectiveclinicalstudyofconsecutivepatientstoexaminetheeffectiveness1.Preparewound2.Apply3.Dresswound.Providesabroadspectrumofthemajorgrowthfactorsforwoundhealingabiologicallyactive,cryopreservedhumanskinallograftwithbothepidermisanddermislayers.Itscellularandextracellularcompositionprovidesasupplyofgrowthfactors,cytokinesandcollagentopromotewoundhealing./upload/docs/Healthcare%20Services/Wound-Healing/retrospective-study2.pdfEpicel?

(GenzymeTissueRepair).Epicelisaculturedautograftcomposedoflivingkeratinocytes.Theproductismadefromabiopsyofthepatient’sownskin,whichissubsequentlyculturedforthreeweeks.

Ithasnodermalcomponentandisaccordinglysu