Progress in developing decellularized bioscaffolds for enhancing skin construction

Abstract

The skin is the largest organ in the human body, and skin defects are very common. Skin flap transplantation is the best treatment for serious wound defects, and donor site tissues are always sacrificed during this process. Decellularized biomaterials, derived mainly from various nonautologous organs and tissues, have promising applications in tissue engineering and repair of wound defects. To date, decellularized mesothelium, intestine, amniotic membrane, dermis, and skin flaps have been developed and applied for skin coverage in animal models and clinical practice. In this review, we discuss recent advances in decellularized biomaterials for skin substitutes and future perspectives. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 1849–1859, 2019.

Bioengineered Skin Substitutes: The Role of Extracellular Matrix and Vascularization in the Healing of Deep Wounds

“…In general, this kind of decellularized dermis is similar to porous scaffolds and is used for hemostatic applications. Other kinds of decellularized matrices are derived from the mesothelium, including peritoneum, pleura and pericardium [27,66,67]. Decellularized peritoneum is obtained using detergent agents and the processes are designed to maximize the preservation of the extracellular matrix architecture and composition.…”

“…Decellularized mesothelium of porcine origin is used, for instance, in breast reconstruction. Bovine sources are another font of decellularized mesothelium showing a faster healing process than that observed for other decellularized dermis substitutes such as Alloderm ® [27]. The intestine is another source to obtain decellularized extracellular matrices.…”

“…Nevertheless, such a process induces the reduction of anti-inflammatory and anti-scarring components by reducing their superiority compared to other matrices. Clinical applications can be found in the reconstruction of the ocular surface, while different studies have been performed on skin reconstruction in nude mice models [27].…”

“…In addition to economics, safety and regulatory (in case of allogenic or xenogeneic materials) concerns, in this work the currently available skin substitutes will be reviewed in the light of the composition of the dermis compartment and how this can affect the regeneration process. DRT can be fabricated starting from connective tissues of either allogenic or xenogeneic origin after removal of the cellular component [27,28]. The decellularization processes remove the associated risk of transmission of pathogens, preserving the composition of the ECM.…”

“…On the other hand, the functionality of molecules of the ECM resulting from the decellularization processes compromise the correct signal presentation to the cells [16][17][18]. Pre-cellularization with endothelial cells, fibroblasts and keratinocytes seems to improve the biological performance of reconstructed three-dimensional matrices of both natural or synthetic origins [2,27,[29][30][31], by speeding up the vascularization, the synthesis of neodermis, the take of the STSG and the closure of the wounds [32][33][34]. Nevertheless, the reconstructed three-dimensional matrices used to accommodate living cells prior to the implant are composed of exogenous biomatrices that possess composition, stiffness and three-dimensional arrangements that are quite different from the native dermis.…”