Wound Healing: From Epidermis Culture to Tissue Engineering

The skin is the largest organ of the individual, being the interface between the body and the microenvironment. In severely burned patients and other diseases, the physiological processes of wound healing are not sufficient to complete the closure of their wounds. The in vitro culture of autologous epidermis, which has represented the beginning of Tissue Engineering, is a valuable tool for the treatment of these patients. Keratinocytes can be cultured and stratified in vitro, and an entire epidermal sheet can be obtained. The epidermis cells can be amplified in the laboratory from a skin sample to obtain a surface equivalent to that required for each patient. This technology was first used clinically in 1981 and in Argentina since 1991. Wound repair is a complex process that involves dermal and epidermal cells, extracellular matrix, soluble factors and the sum of interactions between them, providing physical, biological and chemical keys capable of guiding cell function. Seeking to improve the results obtained with cultured epidermis, tissue engineering was directed towards the development of substitutes that not only involve epidermis but also the dermal component. The tissue engineered skin and its therapeutic applications reported in this review demonstrate the feasibility and effectiveness of these approaches. It represents a clear benefit in wound healing. Now, focus must be directed on the development of new scaffolds, developed by different technologies, such as polymer science, or nanotechnology, able to be used as templates to direct the growth of cells, in an attempt to better regenerate the lost skin.