Bioengineering the Skin–Implant Interface: The Use of Regenerative Therapies in Implanted Devices

Abstract

This discussion and review article focuses on the possible use of regenerative techniques applied to the interfaces between skin and medical implants. As is widely known, the area of contact between an implant and the skin--the skin-implant interface--is prone to recurrent and persistent problems originated from the lack of integration between the material of the implant and the skin. Producing a long-term successful biointerface between skin and the implanted device is still an unsolved problem. These complications have prevented the development of advanced prosthetics and the evolution of biointegrated devices with new technologies. While previous techniques addressing these issues have relied mostly on the coating of the implants or the modification of the topology of the devices, recent in vitro developed techniques have shown that is possible to introduce biocompatible and possibly regenerative materials at the skin-device interface. These techniques have also shown that the process of delivering the materials has biological effects on the skin surrounding the implant, thus converting bioinert into bioactive, dynamic interfaces. Given that the best clinical outcome is the long-term stabilization and integration of the soft tissue around the implant, this article presents the basis for the selection of regenerative materials and therapies for long-term use at the skin-device interface, with focus on the use of natural biopolymers and skin cell transplantation.

SmartHand: A Sense of Assistive Devices

“…Since the interface requires a direct implantation into the human body, an initial claim of biocompatibility needs to be discussed. Similar to transplants or tissue related technologies where biological tissues need to be combined with synthetic materials, the possibility of rejection remains important to consider (Peramo & Marcelo, 2010). If the body is not compatible with such a device, illness will be observed in addition to the prosthetic being rendered nonfunctional (Tutton, 2009).…”

“…If the body is not compatible with such a device, illness will be observed in addition to the prosthetic being rendered nonfunctional (Tutton, 2009). An additional challenge to placing a device inside the body is that unlike tissues or stem cells, which can be autologous, the machine is a completely foreign object (Peramo & Marcelo, 2010). In this sense, this challenge is the largest scientific barrier to the full implementation of the SmartHand in the health care market.…”

Novel Double Lumen Catheter for Drug Delivery at the Skin- Catheter Interface

“…Our hypothesis is that the delivery of specific biomaterials at this interface will create a dynamic, slowly flowing matrix for skin bio integration and the local administration of drugs or antimicrobials. Our essential concept is to incorporate a reservoir of material that can be slowly extruded at the implant-skin interface to protect the underlying tissue layers from the possibility of infection and inflammation or introduce regenerative materials or therapies, as discussed previously [10].…”

Autologous Cell Delivery to the Skin-Implant Interface via the Lumen of Percutaneous Devices in vitro

“…The concept is then the construction of a dynamic/active biointerface that permits delivery of regenerative materials, including cells, when regeneration is desired. An extended discussion of the advantages of skin-implant interface regeneration was presented previously [5]. Successfully addressing the problems originating at this biointerface will also be helpful to avoid or reduce complications in surgical procedures that require long-term permanent access to internal areas after total implantation [6,7].…”

“…Extending that work, here the possibility of delivering autologous cells through the implant itself is briefly described. While the intention of the delivery of biomaterial suspensions were to demonstrate that the technique is feasible and the biomaterials affected the biology of the skin [8], the delivery of the cells is intended as a proof-of-concept that cell delivery around the skin-implant interface is technically possible, as suggested previously [5] and can possibly be used as a regenerative technique for tissue repair around the implant, in a similar way to the use of keratinocytes suspensions for wound repair [11,12]. …”