List of a few commercially available skin substitutes and their properties
| Sl no. | Skin substitute | Source | Characteristics | Advantages | Limitations | Ref. |
|---|---|---|---|---|---|---|
| 1 | Alloderm SelectTM RTM | Human tissue matrix | Acellular dermal and basement membrane substitute | Intact basement membrane with appropriate dermal porosity | Not guaranteed to be free of all pathogens, high cost, long-term evaluation of carcinogenic or mutagenic potential is pending | [15–17] |
| 2 | Dermagraft® | Cryopreserved human fibroblasts seeded on bioabsorbable mesh | Dermal substitute used for the treatment of diabetic wounds | Treat full-thickness diabetic foot ulcers in patients who have an adequate blood supply | Absence of immune, vascular cells. Not useful for infected wounds | [15] |
| 3 | Glyaderm® | NaOH treated & glycerol preserved human cadaver skin | Acellular dermis is used to reconstruct full-thickness wounds arising from burns and injuries | Cost-effective, eliminate dermal antigenic structures | It is a two-step procedure, where Glyaderm application is followed by split-thickness autograft procedure | [18, 19] |
| 4 | IntegraTM | Dermal substitute consisting of bovine tendon collagen with chondroitin 6 sulfate with silicone surface layer | Acute deep partial-thickness, full-thickness burns, burn reconstruction applications | Availability and shelf storage, promote vascularization in poor recipient sites | Collection of hematomas and seromas is difficult. Lack of intrinsic antibacterial property | [15, 20–25] |
| 5 | MatriDerm® | Bovine source. Collagen-elastin hydrolysate, gamma-treated | Soft tissue defects, full thickness or deep dermal burns, and chronic wounds | Better cosmetic appearance, superior resilience, standardized option | Lack of more scientific evidence | [23, 26] |
| 6 | ApligrafTM | Bi-layered, prepared from neonatal foreskin-derived keratinocytes and fibroblasts with bovine type I collagen | Full-thickness diabetic wounds | Viable method of burn wound treatments, better cosmetic results, shelf-life of 5 days at room temperature | Expensive, short shelf life, instability at the wound bed | [27, 28] |
| 7 | Biobrane® | Inner layer of nylon mesh and an outer layer of silastic | Burn wounds (partial-thickness burns in children) | Experience less pain and requirements of pain medications, reduces time required for wound healing | Permanent scarring in partial-thickness scald wounds | [28] |
| 8 | Hyalomatrix® | Bilayer hyaluronan base scaffold with autologous fibroblast, and outer silicone layer present | Burn wounds and chronic wounds | Delivers hyaluronan to the wound bed | Less rigidity than some collagen-based products, risks separation with tissues under tension | [28, 29] |
| 9 | Transcyte® (or Dermagraft-TC) | Human fibroblast-derived, polymer membrane and newborn human fibroblast cells cultured on a porcine collagen coated nylon mesh | Licensed by the FDA for use in burns | Spontaneous separation occurs which indicates wound bed healing. Biocompatible, protects the burn wound surface from environmental insults | High cost, multiple applications required | [30–32] |
| 10 | Dermagraft® | Similar to Transcyte® but it lacks the silicone layer. Contains viable fibroblasts | Used in diabetic foot ulcers | Stimulate wound healing in chronic wounds | Should be used along with standard wound care regimens, useful in patients who have adequate blood supply to the involved foot | [33, 34] |