INTRODUCTION
Wound care is a major aspect of dermatology. Whether wounds are seen in the postoperative or consultation setting or when managing chronic non-healing ulcerations, dermatologists and dermatologic surgeons should be aware of the various wound treatment options available. Specifically, postoperative wounds after dermatologic surgery are typically managed until healed and, in the case of granulation, this may take weeks to months. While most wounds that are sutured or heal by second intention need only wound care, skin substitutes (SS) are beneficial in select scenarios.
SS are numerous and increasingly used in dermatologic surgery, and it is often difficult to compare these products.1 As with pharmacological and surgical treatments, many factors influence a physician's choice regarding wound care management (eg, indication, efficacy, shelf-life, availability, cost).
The ideal substitute supplements the skin's ability to progress through the main stages of healing: hemostasis, inflammation, proliferation, and remodeling.2 Most SS on the market have at least localized signaling molecules like growth factors and cytokines, living or cryopreserved cells (fibroblasts or keratinocytes), and extracellular matrix molecules to promote scaffolding and structural support. Products are often composed of combinations of these key factors of healing. Additionally, SS provides scaffolding for tissue regeneration and may act as a barrier to lower the risk of infection and fluid loss.
SS may be divided into 7 distinct categories based upon composition: amnion, cultured epithelial autograft, acellular allograft, cellular allografts, xenografts, composites, and synthetics. The authors recognize the value of including specific trade names to assist clinicians in distinguishing between the various SS. Amniotic membrane (AM) SS examples include Epifix ® (MiMedx), NuShield ® (Organogenesis), Revita ® (Wound
SS are numerous and increasingly used in dermatologic surgery, and it is often difficult to compare these products.1 As with pharmacological and surgical treatments, many factors influence a physician's choice regarding wound care management (eg, indication, efficacy, shelf-life, availability, cost).
The ideal substitute supplements the skin's ability to progress through the main stages of healing: hemostasis, inflammation, proliferation, and remodeling.2 Most SS on the market have at least localized signaling molecules like growth factors and cytokines, living or cryopreserved cells (fibroblasts or keratinocytes), and extracellular matrix molecules to promote scaffolding and structural support. Products are often composed of combinations of these key factors of healing. Additionally, SS provides scaffolding for tissue regeneration and may act as a barrier to lower the risk of infection and fluid loss.
SS may be divided into 7 distinct categories based upon composition: amnion, cultured epithelial autograft, acellular allograft, cellular allografts, xenografts, composites, and synthetics. The authors recognize the value of including specific trade names to assist clinicians in distinguishing between the various SS. Amniotic membrane (AM) SS examples include Epifix ® (MiMedx), NuShield ® (Organogenesis), Revita ® (Wound
