Tissue Engineered Skin: Apligraf®
According to the Centers for Disease Control (CDC), 1.1 million burn injuries require medical attention in the US per year:
-- Approximately 55,000 burn cases require hospitalization
-- Approximately 20,000 are major burn injuries covering at least 25% of the body (
-- Approximately 4,500 burn victims die per year
With regards to the prevalence of ulcers, a recently published paper, Update on Tissue Engineered Biological Dressings (Ehrenreich et al, 2006) documented that venous leg ulcers occur in 0.18 - 1.35% of the population while pressure ulcers are found in 5.0 - 8.8% of institutionalized patients and 14.8% of patients in acute care facilities. Due to neuropathy (loss of sensation in the extremities) caused by poor maintenance of blood sugar levels, many diabetics develop ulcers as well. Between 4.4 - 10.5% of diabetics experience diabetic ulcers, resulting in 82,000 lower extremity amputations per year.
The need for skin substitutes is entirely evident making the development of tissue engineered skin all the more necessary. The first generation of approved engineered skin has already been produced: Dermagraft®, Apligraf®, Cultured Epidermal Autograft (Epicel®), and OrCel®. Despite, the slow market uptake these products are sure to be used more and more in the coming years with more development and advancement in this field. The focus of this site will be Apligraf®, a full thickness autologous (self i.e. recipient derived) epidermal/dermal skin graft that has a lot of potential.
In the US there is demand for skin substitutes. The skin serves as the bodies defense to trauma, pathogens, and the environment. Defects in the skin caused by burns (figure 2), venous (figure 1) , diabetic (figure 3), and pressure ulcers, and acute injuries can sometimes be life threatening and require skin products. Tissue Engineered skin may be a solution to providing autologous (derived from self) engineered skin.
Figure 2. (From NIH)
Figure 1. (From NIH)
Figure 3. (From Metrohealth.org)