Bioartificial skin.

The loss of skin has been one of the oldest, yet most frequent and costly problems in our health care system. To restore functional and esthetic integrity in patients with unstable or hypertrophic scars, in burn patients and after skin loss for hereditary, traumatic or oncological reasons, an armamentarium of reconstructive surgical procedures including autogenous, allogenous and xenogenous tissue transfer as well as implantation of alloplastic materials has been favored. For several decades there has been increasing interest focused on 'tissue engineering' of dermal, epidermal and full thickness skin substitutes by both biological and synthetic matrices. At our institution (Hannover Medical School), a collagen/glycosaminoglycan dermal regeneration matrix has been used for immediate dermal coverage after escharectomy in burn injuries as well as for dermal replacement in chronically unstable scars. This article gives an overview on the current state of the art in bioartificial skin as well as our personal experience with the collagen/glycosaminoglycan matrix for dermal replacement in different clinical situations.