Table 6.

Main biomaterials used for tissue-engineered skin substitutes (TESSs) considering clinical studies.

Biomaterial	Type of clinical TESSs fabricated	Advantages	Drawbacks	References
Collagen	CESs, CDSs, CSSs, and hMSC-based TESSs	Most abundant animal protein High tensile strength and stability	Lack of intrinsic angiogenic properties	56,60–65,87,90,93,95,101,106,172,173
Collagen-glycosaminoglycan	CSSs and hMSC-based TESSs	Glycosaminoglycan increases mechanical properties and fibril formation of collagen	Requires cross-linking	86,88,89,91,92,104,175
Hyaluronic acid	CDSs, CSSs and hMSC-based TESSs	Ease to handle Biosafety corroborated by its use in cosmetic field Angiogenic properties	Less mechanical properties in comparison with collagen	55,60–65,97,172
Plasma/fibrin	CESs, CSSs, and hMSC-based TESSs	Composed of proteins that participate in wound healing Enhances cell proliferation	Combination with other biomaterials is required to increase mechanical properties	49,51,94,96,98,102,103,177
Amniotic membrane	CDSs and hMSC-based TESSs	High tensile strength Releases several growth factors for angiogenesis and cell proliferation	Difficult to obtain	68,178
Acellular dermal matrix	CESs, CDSs. CSSs, and hMSC-based TESSs	ECM components similar to native human Minimizes the host response	Specific formation is required to obtain and more time	53,67,99,100,105,174

CES cultured epithelial substitute, CDS cultured dermal substitute, CSS composite skin substitute, hMSC mesenchymal stem cell, TESS tissue-engineered skin substitute.