Table 3.
Current synthetic substitutes, composition, and indications
| Synthetic skin substitute | Composition | Indications |
|---|---|---|
| Biobrane® (UDL Laboratories, Inc., Rockford, IL, USA) | Acellular, bi‐layered: inner nylon or silicone mesh layer enables fibrovascular ingrowth and outer silastic layer (porcine collagen) serves as a bacterial barrier | Can replace dermis and epidermis (full‐thickness substitute), and is used in the management of burns, particularly partial‐thickness until wound healing is achieved |
| Dermagraft® (Intercytex Ltd., Manchester, UK) | Cellular (allogenic neonatal fibroblasts), single‐layered: synthetic bioabsorbable polyglactin mesh impregnated with allogenic neonatal fibroblasts | Dermal substitute used for burns, chronic wounds, and ulcers |
| Integra® (Integra LifeSciences Corp., Plainsboro, NJ, USA) | Acellular, bi‐layered: silastic silicone membrane, bovine collagen Type I dermal analog that integrates with the patient's cells and incites dermal regeneration | Can replace dermis and epidermis (full‐thickness substitute, FTS), and is used for deep partial‐thickness and full‐thickness burn wounds, full‐thickness skin defects, chronic wounds and soft tissue defects |
| Apligraft® (Organogenesis, Inc., Canton, MA, USA, and Novartis Pharmaceuticals Corp., East Hanover, NJ, USA) | Cellular (allogenic neonatal keratinocytes and fibroblasts), bi‐layered: Type I bovine collagen and allogenic keratinocytes and neonatal fibroblasts | Can replace dermis and epidermis (FTS), and is used for partial to full‐thickness burns, skin graft donor sites, chronic wounds, diabetic ulcers, and epidermolysis bullosa |
| Matriderm® (MedSkin Solutions Dr Suwelack AG, Billerbeck, Germany) |
Acellular, single‐layered: bovine Type 1 collagen matrix provides structural support for ingrowth of blood vessels and cells, and α‐elastin hydrolysate improves stability and elasticity of regenerating tissue Fibroblasts lay down extracellular matrix and the Matriderm resorbs as the healing process continues |
Dermal substitute used for full‐thickness or deep dermal burns, and chronic wounds |
| OrCel® (Ortec International, Inc., New York, NY, USA) | Cellular (allogenic neonatal keratinocytes and fibroblasts), bi‐layered: cellular matrix with normal human allogenic keratinocytes and dermal fibroblasts cultured into two separate layers into a Type I bovine collagen sponge | Can replace dermis and epidermis (FTS) and is used for chronic wounds and skin graft donor sites |
| Hyalomatrix® (Anika Therapeutics, Inc., Bedford, MA, USA) | Acellular, bi‐layered: hyaluronan base scaffold (delivers hyaluronan to wound bed) with autologous fibroblast and outer silicone membrane (temporary epidermal barrier) | Can replace dermis and epidermis (FTS) and is used for burn wounds and chronic wounds |