Simultaneous in vivo regeneration of neodermis, epidermis, and basement membrane

Full-thickness skin loss does not undergo complete spontaneous regeneration in mammals. To restore the normal function of skin, dermal and epidermal components can be supplied by grafting various substrates, concurrently or in stages. A tissue-engineering technique that combines disaggregated autologous keratinocytes and a highly porous, acellular collagen-glycosaminoglycan matrix has been shown in a porcine model to regenerate a dermis and epidermis in vivo. During regeneration, a basement membrane of normal appearance forms at the dermoepidermal junction, and vascularization of the construct occurs. Cell-seeded grafts can be produced with either uncultured or cultured keratinocytes and can be immediately applied in a single grafting procedure. The seeding process itself and the cell culture, when used, markedly expand the donor epithelial surface area, allowing large skin defects to be repaired using grafts created from very little donor tissue. This skin-substitute technology may have useful clinical applications.