Skin substitutes

On tissue engineering field the research about skin substitutes represents historically the most promising approach to heal acute and chronic skin wounds, reducing requirements for donor skin autografts. Aim of this chapter is to made the state of art of the most important skin substitutes and to resume the principal tissue engineering techniques for its in vitro reconstruction. In the first part we will pay the attention to the description of the evolutive course of skin substitutes, stressing the main steps happened thanks to the important inputs coming from biotechnologies progresses and clinical practice. Since then the research in bioengineering skin, moved by clinical pressing of reconstructive and burn surgery, made progresses trying to develop cutaneous substitutes very similar to native skin by a morpho-functional point of view. So it has been possible, starting from a 2X2 cm skin human biopsy, to realize completely autologous cutaneous substitutes not only composed of two many structures of skin, dermis and epidermis, but containing also other important components: microvascular network, micro nervous network, skin immonocompetent system and melanocyte system. The final goal is to develop effective and easy handling skin substitutes that could be reproduce human skin anatomy and physiology, introducing new advantages linked to successful grafting and then to satisfactory clinical results by functional and aesthetic point of view.