Skin Tissue Engineering
The skin is the largest organ in the body making up 16 % of body weight, with a surface area of 1.8 m2. Because it interfaces with the environment, skin primarily serves as a protective barrier allowing and limiting the inward and outward passage of water
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Skin Tissue Engineering Maike Keck, David Benjamin Lumenta, and Lars-Peter Kamolz
The skin is the largest organ in the body making up 16 % of body weight, with a surface area of 1.8 m2. Because it interfaces with the environment, skin primarily serves as a protective barrier allowing and limiting the inward and outward passage of water, electrolytes and various substances while providing protection against microorganisms, ultraviolet radiation, toxic agents and mechanical insults. An injury of large portions of skin, as in severely burned patients, may result in significant disability or even death. Limitations in the use of autografts and local and free flaps in patients with skin and soft tissue loss have lead to the development of tissue-engineered skin. The term tissue engineering came up in 1987 as a result of combining knowledge from the field of engineering and biology to create bioartificial tissue for regenerative medicine. The development of a bioartificial skin would facilitate the treatment of patients with deep burns and various skin-related disorders, but this approach also has to meet high demands with respect to the interaction of the bioartificial devices and the natural tissues of the human body. A multidisciplinary approach including experts in biomaterial development, cell–matrix interaction, angiogenesis, tissue engineering, simulation, design and fabrication methods is mandatory to succeed in this complicated field. Adult skin consists of three layers: a keratinised, stratified epidermis, an underlying layer of collagen-rich dermal connective tissue, and subcutaneous adipose tissue (hypodermis). Appendages such as hair and glands are derived from the epidermis,
M. Keck, MD (*) Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University Vienna, Vienna, Austria e-mail: [email protected] D.B. Lumenta, MD • L.-P. Kamolz, MD, MSc Division of Plastic, Aesthetic and Reconstructive Surgery, Research Unit for Tissue Regeneration, Repair and Reconstruction, Department of Surgery, Medical University of Graz, Graz, Austria L.-P. Kamolz, D.B. Lumenta (eds.), Dermal Replacements in General, Burn, and Plastic Surgery, DOI 10.1007/978-3-7091-1586-2_2, © Springer-Verlag Wien 2013
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but they project deep into the dermal layer. The epidermis is thin and totally cellular. The epidermis is also exposed to ultraviolet radiation, and the resulting damage is one of the factors contributing to the constant sloughing of cells from the stratum corneum, which are replaced by migrating cells from the basal layers (Alonso and Fuchs 2003). The dermis consists of collagen with some elastin and glycosaminoglycans. Fibroblasts present the major cell type of the dermis and play a major role in wound healing since they are capable of producing remodelling enzymes such as proteases and collagenases. The hypodermis is composed mainly of fat and loose connective tissue and contributes mostly to mechanical as well as thermoregulatory properties of the skin. Great effo
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