169:
and left for several days. Then, the epidermal layer is removed and replaced with artificial epidermis. The dermal equivalent, or neodermis layer, is not removed as it is suitable for growth of cells and vessels. The two layer process, however, may potentially lead to an infection due to any unwanted
187:
for the epidermal layer. The polysiloxane epidermal layer is semipermeable, allowing for the controlled water vapor loss, flexible anti-bacterial support of the wound, and mechanical strength for the dermal equivalent. The dermal layer scaffold promotes vascularization and generation of a neodermis.
119:
when he was able to isolate and grow embryonic tissues from frogs in his laboratory. In 1975, keratinocytes, which are cells that account for the majority epidermal skin cells, were first isolated and successfully cultured in vitro by James G. Rheinwald and Howard Green. Afterwards, in 1981, bilayer
88:
has been common practice for treating individuals who have a need for skin transplants. However, there is the issue of needing repeated grafts or transplants for patients with serious injuries such as burn victims, leading to numerous problems including lack of supply of the skin, preservation, and
100:
There are potential risks when it comes to the application of any dermal equivalent, as there is with any skin grafting or skin substitution technique. These concerns include but are not limited to a negative immune response, possible infection, slow healing, pain, and scarring.
178:
Formerly known as
Integra artificial skin, Integra Dermal Regeneration Template, or IDRT, was the first FDA approved product for dermal replacements. The Integra Dermal Regeneration Template’s bilayer structure is composed of bovine tendon
236:
that are secreted by the fibroblasts. It can promote re-epithelization, however, there is a potential for antigenic response. Dermagraft is mainly used for the treatment of chronic wounds such as various ulcers including
152:
The initial research of dermal equivalent leading to the
Integra product resulted in a bilayer structure consisting of a dermal portion and epidermal portion. The dermal portion is composed of bovine hide collagen and
136:, was developed from Burke et al.'s innovation. It became the first commercial product approved by the FDA for dermal replacements and listed as one of the "Significant Medical Device Breakthroughs" in 1996.
131:
Burke’s dermal graft was one of the earliest developments of the dermal equivalent, or “neodermis”. Years later, Integra artificial skin, which is now called
Integra Dermal Regeneration Template (IDRT) by
144:
There are a variety of dermal equivalents from how they are developed and what they are used for. The following three are some of the most commonly reviewed and assessed dermal equivalents.
77:
A number of commercial dermal equivalents with different compositions and development methods are available. These include
Integra, AlloDerm, and Dermagraft, among others.
495:
Rheinwald JG, Green H (November 1975). "Serial cultivation of strains of human epidermal keratinocytes: the formation of keratinizing colonies from single cells".
89:
the possibility if disease transmission. Thus, this prompted for the development of various techniques to create artificial skin, including dermal equivalents.
602:
92:
Now, the use of dermal equivalents has expanded from burn wounds to other areas such as various reconstructive surgeries and treatment of chronic wounds.
212:
and orbital surgeries, and breast surgeries. Due to its acellular structure, there is no immunogenic response caused from the application of AlloDerm.
892:"Regenerative Potential of Enamel Matrix Protein Derivative and Acellular Dermal Matrix for Gingival Recession: A Systematic Review and Meta-Analysis"
109:
The development of artificial skin and dermis began in the 20th century. It was prompted by the discovery of the ability to isolate and culture cells
843:"The application of an acellular dermal allograft (AlloDerm) for patients with insufficient conjunctiva during evisceration and implantation surgery"
188:
Similar to its predecessor, the method of application is the same. IDRT has low risks of immunogenic response, as well as low disease transmission.
479:
204:
from the collagen fiber network after the removal of the epidermal layer of the cadaveric skin. It is widely used in dental surgeries for
38:
of skin. There is no specific way of forming a dermal equivalent, however the first dermal equivalent was constructed by seeding dermal
1106:
775:
285:
Newton PM, Watson JA, Wolowacz RG, Wood EJ (August 2004). "Macrophages restrain contraction of an in vitro wound healing model".
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Buinewicz B, Rosen B (February 2004). "Acellular cadaveric dermis (AlloDerm): a new alternative for abdominal hernia repair".
51:
233:
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58:. Other cell types may be incorporated into the dermal equivalent to increase the complexity of the model. For example,
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and venous foot ulcers. It received premarket approval from the FDA in 2001 for the treatment of diabetic foot ulcers.
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accumulation between the layers. The main and primary use of
Integra was for burn victims who required skin grafts.
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54:
may be used to screen for treatments which promote or inhibit contraction and thus affect the development of a
128:, and other researchers, which was successful in covering “physiologically close to 60% of the body surface.”
116:
555:"Successful use of a physiologically acceptable artificial skin in the treatment of extensive burn injury"
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covering the dermis. For application, the bilayer structure is placed on the wound after removal of the
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943:"Acellular dermal matrices: Use in reconstructive and aesthetic breast surgery"
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Shaikh MS, Lone MA, Matabdin H, Lone MA, Soomro AH, Zafar MS (February 2021).
603:"Artificial Skin: The Innovation That Changed Complex Burn Wound Care Forever"
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629:"Annual Report Fiscal Year 1996 (October 1, 1995 - September 30, 1996)"
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719:"Skin Tissue Substitutes and Biomaterial Risk Assessment and Testing"
371:"Skin substitutes: a brief review of types and clinical applications"
166:
35:
1129:
553:
Burke JF, Yannas IV, Quinby WC, Bondoc CC, Jung WK (October 1981).
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Greenfield E, Jordan B (June 1996). "Advances in burn wound care".
55:
462:
McGrath JA (2004). "Anatomy and
Organization of Human Skin".
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gel. This gel may then be allowed to contract as a model of
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224:–derived dermal replacement. It is derived from neonatal
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may be incorporated to model the inflammatory phase of
997:"Dermagraft: Use in the Treatment of Chronic Wounds"
790:
788:
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and chondroitin-6-sulfate for the dermal layer, and
995:Hart CE, Loewen-Rodriguez A, Lessem J (June 2012).
665:Kirsner RS, Falanga V, Eaglstein WH (June 1998).
120:artificial skin or dermal graft was developed by
717:Savoji H, Godau B, Hassani MS, Akbari M (2018).
466:. John Wiley & Sons, Ltd. pp. 45–128.
423:"On the possibility of establishing skin banks"
333:Critical Care Nursing Clinics of North America
723:Frontiers in Bioengineering and Biotechnology
115:, which was in 1907 by American embryologist
8:
1096:"Summary of Safety and Effectiveness Data"
1046:"Tissue engineered human skin equivalents"
1044:Zhang Z, Michniak-Kohn BB (January 2012).
627:Office of Device Evaluation (2009-01-20).
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369:Alrubaiy L, Al-Rubaiy KK (January 2009).
62:may be seeded on the surface to create a
841:Park SJ, Kim Y, Jang SY (January 2018).
947:The Canadian Journal of Plastic Surgery
769:"Integra® Dermal Regeneration Template"
667:"The development of bioengineered skin"
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161:. The epidermal portion is composed of
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941:Macadam SA, Lennox PA (2012-05-01).
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174:Integra Dermal Regeneration Template
140:Commercial products and applications
809:10.1097/01.sap.0000100895.41198.27
427:British Journal of Plastic Surgery
299:10.1023/B:IFLA.0000049045.41784.59
14:
1112:from the original on 2017-01-27.
781:from the original on 2021-03-25.
571:10.1097/00000658-198110000-00005
607:ITT Blog | Integra LifeSciences
228:implanted into a bioabsorbable
200:(ADM) derived from the skin of
464:Rook's Textbook of Dermatology
196:AlloDerm is the first type of
52:collagen gel contraction assay
1:
684:10.1016/S0167-7799(98)01196-2
509:10.1016/s0092-8674(75)80001-8
440:10.1016/s0007-1226(51)80028-6
421:Pickerill HP (October 1951).
345:10.1016/S0899-5885(18)30336-8
234:extracellular matrix proteins
1103:Food and Drug Administration
1063:10.3390/pharmaceutics4010026
637:Food and Drug Administration
208:, abdominal hernia repair,
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959:10.1177/229255031202000201
797:Annals of Plastic Surgery
472:10.1002/9780470750520.ch3
232:mesh scaffold along with
157:that is crosslinked with
909:10.3390/proteomes9010011
736:10.3389/fbioe.2018.00086
1013:10.1089/wound.2011.0282
671:Trends in Biotechnology
198:acellular dermal matrix
117:Ross Granville Harrison
1001:Advances in Wound Care
266:Regeneration in humans
220:Dermagraft is a human
261:Regenerative medicine
155:chondroitin 6-sulfate
859:10.1038/eye.2017.161
375:Oman Medical Journal
239:diabetic foot ulcers
134:Integra LifeSciences
86:Autotransplantation
1145:2021-10-07 at the
1105:. September 2001.
387:10.5001/omj.2009.2
251:Tissue engineering
226:dermal fibroblasts
22:dermal replacement
18:dermal equivalent,
559:Annals of Surgery
481:978-0-470-75052-0
206:gingival grafting
126:Ioannis V. Yannas
48:wound contraction
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34:model of the
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36:dermal layer
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230:polyglactin
68:macrophages
40:fibroblasts
1140:Dermagraft
651:2021-10-27
613:2021-10-27
381:(1): 4–6.
272:References
222:fibroblast
216:Dermagraft
902:(1): 11.
896:Proteomes
26:neodermis
1156:Category
1143:Archived
1135:AlloDerm
1107:Archived
1082:24300178
1031:24527294
977:23730154
928:33668721
877:28799557
825:46170403
817:14745271
776:Archived
755:30094235
525:53294766
449:14886567
405:22303500
307:15673162
245:See also
202:cadavers
192:AlloDerm
181:collagen
163:Silastic
112:in vitro
44:collagen
31:in vitro
28:, is an
1130:Integra
1073:3834903
1022:3623576
968:3383551
919:8005981
868:5770710
746:6070628
693:9652135
589:6792993
580:1345315
517:1052771
396:3269619
353:8716388
315:9612298
148:Integra
105:History
81:Purpose
50:. This
42:into a
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1099:(PDF)
821:S2CID
779:(PDF)
772:(PDF)
645:(PDF)
632:(PDF)
521:S2CID
311:S2CID
96:Risks
66:, or
1078:PMID
1027:PMID
973:PMID
924:PMID
873:PMID
813:PMID
751:PMID
689:PMID
585:PMID
513:PMID
497:Cell
476:ISBN
445:PMID
401:PMID
349:PMID
303:PMID
56:scar
16:The
1068:PMC
1058:doi
1017:PMC
1009:doi
963:PMC
955:doi
914:PMC
904:doi
863:PMC
855:doi
847:Eye
805:doi
741:PMC
731:doi
679:doi
575:PMC
567:doi
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