A skin substitute is a product designed to mimic the skin’s structure and function to promote the healing and closing of skin wounds. One of the main uses for skin substitutes is treating diabetic foot ulcers.
Diabetic nerve disease and diabetic vascular disease can set the stage for foot ulcers, breaks in the skin of the foot caused by infection or injury. Diabetic nerve disease (neuropathy) can cause people to lose sensation in the feet, so they’re not aware of injuries when they occur nor of lingering sores on the soles of their feet. In addition, poor circulation in the feet can slow healing of sores. If ulceration occurs and isn’t properly treated, the foot’s underlying bones may become infected, and eventually some part of the foot or leg must be removed to save the patient’s life.
Doctors typically treat foot ulcers by draining accumulated pus, cutting away dead or diseased tissue, and administering antibiotics. Foot ulcers that fail to heal in a timely fashion are treated more aggressively, sometimes with skin substitutes.
Skin substitutes were first developed as an alternative to skin grafts for burn patients, but they’re now primarily used to treat chronic wounds, which are more common than burns. Skin substitutes adhere to the wound area, providing the functional benefits of skin while promoting the natural regeneration of lost tissue.
There are two types of skin substitutes. Cellular substitutes come from animals (called xenogenic sources), the patients themselves (autologous source), or from other humans (allogenic sources). Biomedical skin substitutes don’t contain cells, but are derived from natural sources such as cadaver skin or synthetic sources such as degradable polymers. The biomaterial provides a matrix that allows infiltration by the body’s surrounding cells.