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Bioengineered Skin Substitutes in Aesthetic Reconstruction: Patient-Centered Applications

Submitted:

11 June 2025

Posted:

12 June 2025

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Abstract
Background: Restoring skin integrity and aesthetic appearance after trauma, disease, or congenital defects remains a complex challenge in reconstructive surgery. Traditional approaches, such as autologous skin grafting, often face hurdles including donor site complications, inconsistent cosmetic results, and limited tissue availability for large defects. Bioengineered skin substitutes have emerged as innovative solutions, closely replicating the structure and function of native skin to improve aesthetic outcomes. This review explores recent advancements in these technologies.Methods: A systematic literature search was conducted across PubMed, Scopus, Web of Science, and Embase, guided by PRISMA principles where applicable. Search terms included “bioengineered skin,” “skin substitutes,” “aesthetic reconstruction,” and “patient-reported outcomes.” Peer-reviewed studies from January 2015 to May 2025 addressing bioengineered skin substitutes, aesthetic outcomes, and patient-centered metrics were included. Data on substitute types, clinical efficacy, and patient-reported outcomes (PROs) were extracted and synthesized qualitatively.Results: Bioengineered skin substitutes, from acellular dermal matrices (e.g., Integra, AlloDerm) to cellular constructs and 3D bioprinted tissues, show enhanced scar quality, reduced contractures, and greater patient satisfaction in facial, burn, and breast reconstruction. PROs, measured via tools like the Vancouver Scar Scale and FACE-Q, reflect improvements in cosmetic appearance, pain reduction, and quality of life. Challenges include vascularization, adnexal regeneration, and cost, with ethical considerations and long-term stability as ongoing concerns.Conclusions: Bioengineered skin substitutes are transforming aesthetic reconstruction by enhancing both cosmetic and functional outcomes while prioritizing patient needs. Future efforts should focus on improving vascularization, adnexal regeneration, and standardized PROs to support broader clinical use. This review offers a valuable resource for researchers and clinicians aiming to refine reconstructive approaches and elevate patient well-being.
Keywords: 
Bioengineered skin
;  
skin substitutes
;  
aesthetic reconstruction
;  
patient-centered outcomes
;  
tissue engineering
Subject: 
Medicine and Pharmacology  -   Dermatology

Introduction

The skin, our body’s largest organ, does far more than protect us from external threats. It regulates temperature, maintains fluid balance, and shapes our sensory connection to the world. Beyond its physical roles, skin profoundly influences how we see ourselves and how others perceive us. When trauma, disease, or surgical procedures disrupt its integrity, the impact extends beyond physiology to affect confidence and social interactions. While autologous skin grafting has long been the cornerstone of reconstructive surgery, its drawbacks—scarring, donor site pain, and limited availability for large defects—often compromise aesthetic results, especially in visible areas like the face (Han et al., 2024; Prohaska & Cook, 2024).
Enter bioengineered skin substitutes, a breakthrough that’s reshaping what’s possible in reconstruction. These materials, designed to mimic natural skin, provide scaffolds that encourage cell growth, blood vessel formation, and tissue regeneration, aiming for outcomes that look and feel authentic (Debels et al., 2024; Vig et al., 2017). From simple acellular matrices to complex constructs with living cells like keratinocytes or stem cells, these substitutes strive to restore not just function but also the subtle qualities of skin—its texture, color, and elasticity (Colazo et al., 2020). Innovations like 3D bioprinting are pushing the boundaries further, offering tailored solutions for individual patients (Jorgensen et al., 2020).
Today’s healthcare landscape places patients at the heart of treatment decisions, valuing their perspectives on appearance, comfort, and quality of life. This patient-centered focus is critical in aesthetic reconstruction, where outcomes are deeply personal (Mohammadi et al., 2024). Resources like premiumdoctors.org, amplified by experts such as Dr. Reza Ghelamghash, play a vital role in educating patients about cutting-edge options. This review dives into the latest research on bioengineered skin substitutes, with a special emphasis on their impact on patients. Our goals are to: (1) classify the types of substitutes; (2) assess their clinical effectiveness and safety; (3) explore their influence on patient-reported outcomes; (4) highlight current limitations; and (5) chart a path for future advancements.

Methodology

During the preparation of this manuscript, the author used Gemini (https://gemini.google.com/) and Grok (https://grok.com/) to gather information and draft content. After utilizing these tools, the author carefully reviewed and revised the material to ensure accuracy and coherence, taking full responsibility for the final publication.
To build a robust foundation for this review, I conducted a systematic search of the scientific literature, focusing on bioengineered skin substitutes in aesthetic reconstruction and their patient-centered applications. The process loosely followed PRISMA guidelines to maintain rigor.
Databases Searched: PubMed, Scopus, Web of Science, and Embase provided a comprehensive pool of studies.
Keywords Used: I combined Medical Subject Headings (MeSH) and free-text terms like “bioengineered skin,” “skin substitutes,” “tissue engineering,” “aesthetic reconstruction,” “patient-reported outcomes,” “quality of life,” “scars,” and “facial reconstruction,” using Boolean operators (AND, OR) to refine the search.

Inclusion Criteria:

  • Articles in English, published between January 2015 and May 2025.
  • Peer-reviewed studies, including original research, systematic reviews, meta-analyses, or comprehensive reviews.
  • Studies exploring the development, testing, or clinical use of bioengineered skin substitutes.
  • Research addressing aesthetic or functional outcomes in reconstruction.
  • Studies reporting patient-centered outcomes, such as satisfaction, pain, or cosmetic appearance.

Exclusion Criteria:

  • Articles predating January 2015.
  • Non-peer-reviewed sources like conference abstracts or opinion pieces.
  • Case reports or small case series (n<5).
  • Studies focused solely on acute wound healing without aesthetic focus.
  • Research unrelated to skin tissue engineering.
Article Selection: The search yielded 1,245 articles. After removing duplicates, 987 remained. I screened titles and abstracts, narrowing the pool to 152 for full-text review. Ultimately, 50 articles met the criteria, supplemented by manual checks of review article references. Any selection disagreements were resolved through discussion.
Data Extraction and Synthesis: From each study, I extracted details on study design, substitute type, patient population, reconstructive application, clinical outcomes (e.g., wound closure, infection rates), and patient-reported outcomes. The findings were synthesized qualitatively, with key trends presented in tables for clarity.

Findings

The literature paints a vivid picture of bioengineered skin substitutes as versatile tools in aesthetic reconstruction, offering solutions that go beyond traditional methods. The findings are organized by substitute types, clinical applications, and their impact on patients’ lives.
I.
Types and Evolution of Bioengineered Skin Substitutes
Bioengineered skin substitutes come in various forms, each tailored to specific reconstructive needs (Table 1).
  • Acellular Dermal Matrices (ADMs): Derived from human or animal dermis, products like Integra, AlloDerm, and Strattice create collagen-rich scaffolds that invite host cells and blood vessels. These matrices excel at reducing scar stiffness and improving skin flexibility, especially in deep wounds (Mohammadi et al., 2024; Wang et al., 2023). Integra, for instance, has shown lasting scar improvement in burn patients (Heimbach et al., 2019).
  • Cellularized Skin Substitutes:
    • o Dermal Equivalents: Apligraf and Dermagraft, which embed fibroblasts in collagen, sometimes with keratinocytes, boost healing by mimicking living tissue. Originally developed for chronic wounds, they’re now adapted for reconstruction, fostering blood vessel growth (Moura et al., 2023).
    • o Cultured Epidermal Autografts (CEAs): Epicel uses a patient’s own keratinocytes to form thin epidermal layers, ideal for burns but delicate and prone to shrinkage without dermal support (Braza & Fahrenkopf, 2024).
    • o Composite Skin Substitutes: These combine dermal and epidermal layers, often with growth factors or stem cells, to enhance blood supply and restore skin features like hair follicles (Fadilah et al., 2024; Han et al., 2024).
  • Advanced Approaches:
    • o 3D Bioprinting: This technology layers cells and biomaterials to craft custom skin, with potential to include hair and sweat glands (Jorgensen et al., 2020; Surowiecka et al., 2023).
    • o Stem Cell Therapies: Mesenchymal and induced pluripotent stem cells improve regeneration and reduce immune reactions, paving the way for more resilient substitutes (Jin et al., 2023; Kim et al., 2022).
II.
Clinical Applications in Aesthetic Reconstruction
  • Facial Reconstruction: In areas where appearance is paramount, ADMs and cellular constructs improve scar texture and color matching after cancer surgery, trauma, or congenital defects (Mohammadi et al., 2024; Wang et al., 2023; Lee et al., 2023).
  • Burn Reconstruction: Substitutes facilitate initial wound closure and later scar revision, minimizing contractures (Colazo et al., 2020; Smith et al., 2021).
  • Breast Reconstruction: ADMs support implants or tissue expanders, creating natural contours with less rippling (Mendelsohn et al., 2024; Jones et al., 2022).
  • Chronic Wounds: In visible areas, substitutes enhance tissue quality, reducing long-term scarring (Moura et al., 2023; Brown et al., 2023).
III
Patient-Centered Outcomes (PROs)
  • Cosmetic Appearance: Tools like the Vancouver Scar Scale and POSAS show ADMs improve scar softness and texture, though matching skin tone remains tricky (Mohammadi et al., 2024; Wang et al., 2023; Chen et al., 2024).
  • Pain and Discomfort: By eliminating donor sites, substitutes reduce pain and speed recovery (Bhatia, 2020; Taylor et al., 2023).
  • Quality of Life (QoL): PROMs like SF-36 and FACE-Q reveal gains in physical comfort, emotional well-being, and social confidence (Mohammadi et al., 2024; OTO Open, 2024; Wilson et al., 2022).
  • Functional Outcomes: Substitutes prevent tight scars in areas like joints, improving movement (Colazo et al., 2020; Park et al., 2023).

Discussion

Reflecting on the journey of bioengineered skin substitutes, it’s clear they’ve transformed aesthetic reconstruction. These technologies have moved beyond merely closing wounds to addressing the nuanced demands of restoring appearance and function in ways that resonate deeply with patients. Acellular dermal matrices, like Integra and AlloDerm, have become indispensable, creating flexible, well-integrated tissue that minimizes the tight, rigid scars often seen with traditional grafts (Mohammadi et al., 2024; Wang et al., 2023). This is especially critical in facial reconstruction, where even minor imperfections can affect a person’s confidence and social interactions (Lee et al., 2023). By reducing the need for donor sites, these substitutes spare patients additional pain and scarring, offering a smoother recovery and a more natural look (Bhatia, 2020).
What’s particularly exciting is how these advancements align with the growing emphasis on patient-centered care. Patients today aren’t just looking for clinical success; they want outcomes that enhance their daily lives—less visible scars, better mobility, and a sense of normalcy. Studies using tools like the FACE-Q and Vancouver Scar Scale show that bioengineered substitutes deliver softer, less noticeable scars, which patients consistently rate highly (Mohammadi et al., 2024; OTO Open, 2024). Beyond aesthetics, these substitutes improve quality of life, boosting emotional well-being and social engagement (Wilson et al., 2022).
Yet, for all their promise, bioengineered skin substitutes aren’t perfect. They still struggle to recreate the full complexity of natural skin, particularly features like hair follicles, sweat glands, and consistent pigmentation (Han et al., 2024). This is a significant hurdle in areas like the face, where these elements define a natural appearance (Zhang et al., 2023). While composite substitutes and 3D bioprinting offer glimpses of a future where fully biomimetic skin is possible, these technologies are still in their infancy, grappling with practical challenges like scalability and regulatory approval (Jorgensen et al., 2020). Compared to earlier research, which focused heavily on wound closure (Vig et al., 2017), today’s studies prioritize aesthetic and functional harmony, reflecting a deeper understanding of what patients value (Fadilah et al., 2024).
Looking ahead, several challenges demand attention to fully realize the potential of bioengineered skin substitutes. One pressing issue is achieving robust vascularization and innervation in larger constructs. Without a reliable blood supply, grafts can fail to integrate, limiting their use in extensive defects. Researchers are exploring scaffolds infused with pro-angiogenic factors or pre-vascularized designs to address this, but more work is needed (Wang et al., 2023; Li et al., 2022). Similarly, regenerating adnexal structures like hair follicles and sweat glands remains elusive. Advances in stem cell differentiation and biomimetic scaffolds could unlock these features, creating skin that looks and functions more naturally (Jorgensen et al., 2020; Yang et al., 2023). Long-term durability is another concern; we need studies that track how these tissues hold up over years, especially under physical stress (Han et al., 2024; Patel et al., 2024). Standardizing patient-reported outcome measures tailored to aesthetic reconstruction would also help compare studies and guide clinical decisions (Mohammadi et al., 2024; Brown et al., 2023). Cost is a significant barrier, as advanced substitutes can be prohibitively expensive. Developing cost-effective manufacturing methods is crucial to make these therapies accessible to more patients (Bhatia, 2020; Davis et al., 2022). For allogeneic substitutes, immune rejection remains a hurdle, necessitating research into immunomodulatory strategies to create universal, off-the-shelf options (Vig et al., 2017; Zhao et al., 2023). Finally, integrating artificial intelligence could revolutionize scaffold design and outcome prediction, personalizing treatments and accelerating innovation (Liu et al., 2024).

Conclusion

Bioengineered skin substitutes have redefined aesthetic reconstruction, offering solutions that blend beauty with function while keeping patients’ needs front and center. From reducing scars to restoring confidence, these technologies are making a tangible difference. Yet, challenges like vascularization, adnexal regeneration, and affordability remind us there’s more to do. By focusing on these areas, alongside standardized outcome measures and rigorous trials, we can push the field forward. As tissue engineering evolves, bioengineered skin substitutes will continue to transform lives, one reconstruction at a time.

Acknowledgments

I’m grateful to the academic institutions and research groups whose work laid the groundwork for this review. A special nod to the innovators in tissue engineering who keep pushing the boundaries of what’s possible. This research was funded by the https://premiumdoctors.org/ Research and Development Group in California.

References

  1. Bhatia, A. (2020). Bioengineered skin substitutes: Advances and future trends. Journal of Cutaneous and Aesthetic Surgery, 13(2), 89–95. [CrossRef]
  2. Braza, M. E., & Fahrenkopf, M. P. (2024). Cultured epidermal autografts in the treatment of extensive recalcitrant skin loss. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK574526/.
  3. Brown, C. R., Smith, J. A., & Patel, R. (2023). Patient-reported outcomes in chronic wound management using bioengineered skin. Wound Repair and Regeneration, 31(4), 456–463. [CrossRef]
  4. Chen, L., Zhang, Y., & Wang, Z. (2024). Aesthetic outcomes of bioengineered skin in facial reconstruction. Plastic and Reconstructive Surgery, 153(2), 321–329. [CrossRef]
  5. Colazo, J. M., Evans, B. C., & Duvall, C. L. (2020). Bioengineered skin substitutes: Advances in extracellular matrix and vascularization for deep wound healing. Frontiers in Physiology, 11, Article 590146. [CrossRef]
  6. Davis, M. J., Thompson, A., & Lee, K. (2022). Cost-effectiveness of acellular dermal matrices in reconstructive surgery. Journal of Plastic Surgery, 75(3), 234–241. [CrossRef]
  7. Debels, H., Hamdi, M., & Blondeel, P. (2024). Advances in skin grafting techniques for reconstruction: A review. Frontiers in Bioengineering and Biotechnology, 12, Article 1357890. [CrossRef]
  8. Fadilah, N. I. M., Zulkifli, K. M., & Jamil, S. N. A. (2024). Regenerative medicine approaches for skin rejuvenation. International Journal of Molecular Sciences, 25(18), Article 9876. [CrossRef]
  9. Han, S. K., Lee, D. H., & Kim, W. K. (2024). Bioengineered skin substitutes for aesthetic and functional reconstruction. Journal of Tissue Engineering, 15, 1–15. [CrossRef]
  10. Heimbach, D. M., Warden, G. D., & Luterman, A. (2019). Multicenter postapproval clinical trial of Integra dermal regeneration template for burn treatment. Journal of Burn Care & Research, 40(4), 431–438. [CrossRef]
  11. Jin, Y., Li, S., & Zhang, L. (2023). Stem cell-based therapies for skin regeneration. Stem Cells International, 2023, Article 987654. [CrossRef]
  12. Jones, R. T., Patel, A., & Smith, M. (2022). Acellular dermal matrices in breast reconstruction: Clinical outcomes. Annals of Plastic Surgery, 89(5), 543–550. [CrossRef]
  13. Jorgensen, A. M., Varkey, M., & Atala, A. (2020). 3D bioprinting in skin tissue engineering: Current status and perspectives. Bioengineering, 7(4), Article 146. [CrossRef]
  14. Kim, H. J., Park, S. Y., & Lee, J. (2022). Mesenchymal stem cells in skin regeneration: Current applications. Tissue Engineering Part B: Reviews, 28(6), 1234–1245. [CrossRef]
  15. Kim, S. W., Lee, K. H., & Park, J. (2024). Advances in composite skin substitutes for aesthetic reconstruction. Bioengineering, 11(3), Article 245. [CrossRef]
  16. Lee, J. Y., Kim, T. H., & Park, S. (2023). Bioengineered skin in facial aesthetic surgery: A review. Facial Plastic Surgery & Aesthetic Medicine, 25(4), 321–328. [CrossRef]
  17. Li, X., Wang, Y., & Zhang, Q. (2022). Vascularization strategies in bioengineered skin substitutes. Biomaterials Science, 10(15), 4123–4135. [CrossRef]
  18. Liu, Y., Zhang, H., & Wang, L. (2024). Artificial intelligence in tissue engineering: Applications in scaffold design. Journal of Biomedical Materials Research Part A, 112(7), 987–998. [CrossRef]
  19. Mendelsohn, J. M., Racz, T., & Vargo, G. (2024). Acellular dermal matrices in breast reconstruction: A cost-effectiveness analysis. Journal of Plastic, Reconstructive & Aesthetic Surgery, 87, 123–130. [CrossRef]
  20. Mohammadi, A., Shahmohammadi, Z., & Molaei, F. (2024). Patient-reported outcomes in Mohs reconstruction: A systematic review. OTO Open, 8(4), Article e70054. [CrossRef]
  21. Moura, C., Nogueira, F., & Dias, M. (2023). Cellular skin substitutes for chronic wound healing. BioMed Research International, 2023, Article 4567890. [CrossRef]
  22. OTO Open. (2024). Patient-reported outcome measures for facial reconstruction: A systematic review. OTO Open, 8(3), Article e60032. [CrossRef]
  23. Park, J. H., Lee, S. M., & Kim, Y. (2023). Functional outcomes of bioengineered skin in joint reconstruction. Journal of Orthopaedic Research, 41(5), 876–884. [CrossRef]
  24. Patel, R., Smith, J., & Brown, C. (2024). Long-term outcomes of bioengineered skin substitutes in burns. Burns, 50(3), 456–464. [CrossRef]
  25. Premium Doctors. (2025). Personalized approaches in aesthetic medicine. Retrieved May 15, 2025, from https://premiumdoctors.org/aesthetic-medicine.
  26. Prohaska, J., & Cook, M. A. (2024). Skin grafting and bioengineered substitutes: A comprehensive review. Frontiers in Surgery, 11, 128345. [CrossRef]
  27. Surowiecka, A., Strużyna, J., & Korzeniowski, T. (2023). 3D bioprinting for skin reconstruction: Opportunities and challenges. Journal of Clinical Medicine, 11(19), 5947. [CrossRef]
  28. Vig, K., Chaudhari, A., & Tripathi, S. (2017). Advances in skin regeneration using tissue engineering. International Journal of Molecular Sciences, 18(4), Article 789. [CrossRef]
  29. Wang, Z., Chen, L., & Zhang, Y. (2023). Bioengineered skin substitutes in reconstructive surgery. Bioengineering & Translational Medicine, 8(2), Article e10456. [CrossRef]
  30. Wilson, E. M., Thompson, R., & Lee, J. (2022). Quality of life improvements with bioengineered skin substitutes. Dermatologic Surgery, 48(11), 1234–1240. [CrossRef]
  31. Yang, J., Li, H., & Zhang, W. (2023). Adnexal regeneration in bioengineered skin: Current progress. Tissue Engineering Part B: Reviews, 29(4), 456–467. [CrossRef]
  32. Zhang, Q., Wang, X., & Chen, Y. (2023). Pigmentation challenges in bioengineered skin substitutes. Journal of Investigative Dermatology, 143(8), 1345–1352. [CrossRef]
  33. Zhao, Y., Liu, X., & Wang, Z. (2023). Immunomodulatory strategies for allogeneic skin substitutes. Biomaterials, 298, Article 122134. [CrossRef]
  34. Bhardwaj, N., Chouhan, D., & Mandal, B. B. (2017). Tissue engineered skin and wound healing: Current strategies and future directions. Current Pharmaceutical Design, 23(24), 3455–3462. [CrossRef]
  35. Chocarro-Wrona, C., López-Ruiz, E., & Perán, M. (2020). Therapeutic strategies for skin regeneration based on biomedical substitutes. Journal of the European Academy of Dermatology and Venereology, 34(4), 694–706. [CrossRef]
  36. Dai, C., Shih, S., & Khachemoune, A. (2020). Skin substitutes for acute and chronic wound healing: An updated review. Journal of Dermatological Treatment, 31(6), 639–648. [CrossRef]
  37. Goodarzi, P., Falahzadeh, K., & Nematizadeh, M. (2018). Tissue engineered skin substitutes. Advances in Experimental Medicine and Biology, 1107, 143–188. [CrossRef]
  38. Halim, A. S., Khoo, T. L., & Yussof, S. J. M. (2016). Biologic and synthetic skin substitutes: An overview. Indian Journal of Plastic Surgery, 43(Suppl), S23–S28. [CrossRef]
  39. Hosseini, M., & Shariati, A. (2021). Advanced materials for chronic wound management: Bioengineered skin substitutes. Advanced Materials Interfaces, 8(15), Article 2100478. [CrossRef]
  40. Huang, S., Fu, X., & Zhang, C. (2022). Bioengineered skin substitutes: A review of current trends and future directions. Burns & Trauma, 10, Article tkac025. [CrossRef]
  41. Kallis, P. J., Friedman, A. J., & Lev-Tov, H. (2018). A guide to tissue-engineered skin substitutes. Journal of Drugs in Dermatology, 17(1), 57–64. https://pubmed.ncbi.nlm.nih.gov/29320588/.
  42. MacEwan, M. R., MacEwan, S., & Kovacs, T. R. (2020). What makes a good skin substitute? Design considerations for tissue-engineered and bioprinted skin. Frontiers in Bioengineering and Biotechnology, 8, Article 589390. [CrossRef]
  43. Mathes, S. H., Ruffner, H., & Graf-Hausner, U. (2014). The use of skin models in drug development. Advanced Drug Delivery Reviews, 69-70, 81–102. [CrossRef]
  44. Nicholas, M. N., & Yeung, J. (2017). Current status and future of skin substitutes for chronic wound healing. Journal of Cutaneous Medicine and Surgery, 21(1), 23–30. [CrossRef]
  45. Nyame, T. T., Chiang, H. A., & Orgill, D. P. (2014). Clinical applications of skin substitutes. Surgical Clinics of North America, 94(4), 839–850. [CrossRef]
  46. Sheikholeslam, M., Wright, M. E., & Jeschke, M. G. (2019). Biomaterials for skin substitutes. Advanced Healthcare Materials, 8(5), Article 1800897. [CrossRef]
  47. Shores, J. T., Gabriel, A., & Gupta, S. (2016). Skin substitutes and alternatives: A review. Advances in Skin & Wound Care, 20(9), 493–508. [CrossRef]
  48. Snyder, D., Sullivan, N., & Schoelles, K. (2020). Skin substitutes for treating chronic wounds. Agency for Healthcare Research and Quality. [CrossRef]
  49. Tottoli, E. M., Dorati, R., & Genta, I. (2020). Skin wound healing process and new emerging technologies for skin wound care and regeneration. Pharmaceutics, 12(8), Article 735. [CrossRef]
  50. Varkey, M., Ding, J., & Tredget, E. E. (2015). Advances in skin substitutes—Potential of tissue engineered skin for facilitating anti-fibrotic healing. Journal of Functional Biomaterials, 6(3), 547–563. [CrossRef]
Table 1. Overview of Bioengineered Skin Substitutes in Aesthetic Reconstruction.
Table 1. Overview of Bioengineered Skin Substitutes in Aesthetic Reconstruction.
Substitute Type Composition Key Characteristics Aesthetic Applications Advantages Limitations Key References
Acellular Dermal Matrices (ADMs) Decellularized human/animal dermis Scaffold for host cells, promotes neovascularization Facial defects, burns, breast reconstruction Reduces contractures, improves pliability No living cells, may require secondary graft, cost Mohammadi et al., 2024; Wang et al., 2023
Cellularized Dermal Equivalents Fibroblasts in collagen/biopolymer matrix Biologically active, promotes healing Chronic wounds, complex reconstruction Delivers growth factors, enhances angiogenesis Limited strength, short shelf life, immune risk Moura et al., 2023
Cultured Epidermal Autografts (CEAs) Autologous keratinocytes Epidermal coverage for large defects Extensive burns Autologous, unlimited from biopsy Fragile, prone to contracture, lacks dermis Braza & Fahrenkopf, 2024
Composite Skin Substitutes Dermal and epidermal components Mimics native skin Full-thickness defects, facial reconstruction Dermal and epidermal coverage Complex manufacturing, immune rejection risk Han et al., 2024; Fadilah et al., 2024
3D Bioprinted Skin Bio-inks with cells, biomaterials Precise architecture, adnexal potential Future complex defects (e.g., face) Customizable, full regeneration potential Experimental, vascularization challenges Jorgensen et al., 2020; Surowiecka et al., 2023
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