Biological background of dermal substitutes

van der Veen, Vincent C.; van der Wal, Martijn B.A.; van Leeuwen, Michiel C.E.; Ulrich, Magda M.W.; Middelkoop, Esther

doi:10.1016/j.burns.2009.07.012

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Volume 36, Issue 3 , Pages 305-321, May 2010

Biological background of dermal substitutes

Vincent C. van der Veen
- Association of Dutch Burn Centers, Beverwijk, The Netherlands
Martijn B.A. van der Wal
- Association of Dutch Burn Centers, Beverwijk, The Netherlands
- Burn Center, Red Cross Hospital, Beverwijk, The Netherlands
Michiel C.E. van Leeuwen
- Association of Dutch Burn Centers, Beverwijk, The Netherlands
- Burn Center, Red Cross Hospital, Beverwijk, The Netherlands
Magda M.W. Ulrich
- Association of Dutch Burn Centers, Beverwijk, The Netherlands
- Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands
Esther Middelkoop
- Association of Dutch Burn Centers, Beverwijk, The Netherlands
- Burn Center, Red Cross Hospital, Beverwijk, The Netherlands
- Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands
- Corresponding author at: Association of Dutch Burn Centers, Red Cross Hospital, Postbus 1074, 1940 EB Beverwijk, The Netherlands. Tel.: +31 251265283; fax: +31 251264948.

Accepted 13 July 2009.

Abstract

Dermal substitutes are of major importance in treating full thickness skin defects, both in acute and chronic wounds. In this review we will outline specific requirements of three classes of dermal substitutes:

-natural biological materials, with a more or less intact extracellular matrix structure;

-constructed biological materials, composed of specific biological components; and

-synthetic substitutes, which can be synthesized on demand and can be modulated for specific purposes.

Biological and clinical requirements will be translated to composition, physical structure, immunological properties and cell–matrix interactions of the various materials.

Important properties like pore size, cell adhesion sites (e.g. RGD sequences), crosslinking, degradability and the presence of a basement membrane will be discussed for each of the different classes of materials.

Keywords: Dermal substitutes, Burn wound healing, Biomaterials, Collagen