Regeneration and Repair of Skin Wounds: Various Strategies for Treatment

Abstract

Skin as a mechanical barrier between the inner and outer environment of our body protects us against infection and electrolyte loss. This organ consists of 3 layers: the epidermis, dermis, and hypodermis. Any disruption in the integrity of skin leads to the formation of wounds, which are divided into 2 main categories: acute wounds and chronic wounds. Generally, acute wounds heal relatively faster. In contrast to acute wounds, closure of chronic wounds is delayed by 3 months after the initial insult. Treatment of chronic wounds has been one of the most challenging issues in the field of regenerative medicine, promoting scientists to develop various therapeutic strategies for a fast, qualified, and most cost-effective treatment modality. Here, we reviewed more recent approaches, including the development of stem cell therapy, tissue-engineered skin substitutes, and skin equivalents, for the healing of complex wounds.

Role of stem cell therapies in treating chronic wounds: A systematic review

“…Though their clinical potential has been favorably evidenced, there are some challenges to consider with the use of ADSCs. This cell population is not immortal and displays signs of aging and loss of chemokine markers with repeat culturing[ 50 ]. Further, adipose tissue can widely vary in its metabolic activity and capacity for proliferation and differentiation depending on the site of tissue harvest and patient characteristics, such as age and sex[ 31 ].…”

“…Marfia et al[ 45 ] identified that autologous ADSCs have an altered genotype in diabetic patients, which is characterized by decreased potency and expression of vascular endothelial growth factor-A (VEGF-A) and chemokine receptor CXCR4. Judicious use of ADSC therapy requires close patient surveillance for tumor formation as well as consideration of strategies to improve cell homing and transplantation[ 50 ].…”

“…To enhance their favorable therapeutic profile, BMMSCs can be administered along with platelets, fibrin glue, and bone marrow-impregnated collagen matrix; this strategy has resulted in significant diabetic wound closure in patients with formerly recalcitrant wounds[ 84 ]. Similar to ADSCs, BMMSCs necessitate careful monitoring of patients for possible tumor formation as well as appropriate but not excessive culturing in order to avoid transplantation of aged cells with inferior homing abilities and loss of chemokine markers[ 50 ].…”

“…Bayram et al[ 99 ] found that cultured keratinocytes attached to microcarriers of polyethylene and silica resulted in better cell delivery than keratinocytes administered alone. When considering KSC or keratinocyte therapy, it is important to recognize that these cells can be difficult to isolate, display a short lifespan throughout serial cultivation, and necessitate patient monitoring for tumor formation[ 50 ].…”

Toward a Closed Loop, Integrated Biocompatible Biopolymer Wound Dressing Patch for Detection and Prevention of Chronic Wound Infections

“…A number of strategies have been explored to improve chronic wound outcomes. Tissue engineering approaches, such as the use of stem cells, modulating the immune response, and the use of scaffolds, cell therapies or growth factors are widely reported ( Rezaie et al, 2019 ). Evidence based decision systems have also been developed to progress from decision based support systems ( Schaarup et al, 2018 ) and a large field of research is devoted to the point of care monitoring and analysis of chronic wounds ( Sheets et al, 2016 ).…”