Biomaterials for Skin Wound Repair: Tissue Engineering, Guided Regeneration, and Wound Scarring Prevention

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Background

It is often overseen that the skin or integument is the biggest organ of the human body. Moreover, skin importance spans different fields, from esthetics and social interactions to various diseases and their multiple upshots. Notably, skin and internal organs are bidirectionally related: an organ disease can alter skin structure and function, and vice versa. An example of this mutual relationship is acute or chronic urticaria (hives) with or without angioedema, which affects wide skin areas and is caused by immune reactions to foreign antigens, autoimmunity, malignancy, and so on. The reverse example is a deep and extended burn wound which destroys the skin barrier, preventing the body’s invasion on microorganisms (infections) while simultaneously releasing toxic agents into the circulation, in turn, impairing the internal organs function: both upshots can jeopardize survival.

Despite having a variable prevalence in different countries, severe skin wounds must not be underrated as they impact on several crucial questions, including patients’ prognosis, extent of scarring, scar retraction consequences, body image alterations with their psychological reverberations, as well as social and emotional interactions. Moreover, presently, skin burn wounds are the most common injury for soldiers surviving combat duty. Significantly, with increasing incidence and growing prevalence of lifestyle-related disorders, chronic wounds have become a serious global health issue, causing an enormous financial burden on health care systems worldwide. Recent scientific progress has made an impression on the clinical management of acute and chronic skin wounds, as well as on basic research attempts to clarify the pathophysiological mechanisms involved in healing, with the aim to improve upshots and their healthcare, economic, and social consequences.

A first important field of endeavor concerns the prevention or mitigation of wound scarring and scar retraction. This involves surgical and pharmacological interventions, experimental studies using ad hoc living animal models, in vitro cell culture systems, stem cell applications, molecular biology and biochemical methods, proteomic analyses, and histopathological and immunohistochemical imaging. A second relevant field of endeavor has emerged ex novo from the rapidly developing biomaterials science. It has engendered the dream of engineering the human skin with its own layers and appendages through the availability of ad hoc biomaterial scaffolds acting as guides for proliferating cells and vessels. Such scaffolds are undergoing tests in vitro and in vivo using animal models with the intent to translate them into the clinical setting. The target is identifying the golden scaffold whose beneficial features would be biocompatibility, non-immunogenicity, tolerability, neovascularization, and optimal biomechanics, as well as excess scarring (keloid) and scar retraction prevention.

Therefore, this Research Topic focuses on basic and applied research works aimed at optimizing extended and deep burn wound and chronic wound healing, as well as at preventing or mitigating scar hypertrophy/retraction. It welcomes studies using biomaterials of natural origin or artificial synthesis aimed at the same purposes. Investigations exploiting wound biofilms, cell therapy, and 3D printing are also encouraged.
This Research Topic is specifically interested in original researches, clinical trials, reviews and systematic review articles.

Dr. Giuliano Freddi is Chief Scientific Officer and co-founder of the company Silk Biomaterials srl. All other Guest Editors declare no competing interests with regards to the Topic subject.

Keywords: Skin wounds, burns, ulcers, tissue engineering, biomaterial-guided regeneration, scar hypertrophy, scar retraction

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