This PowerPoint presentation entails the description of artificial skin and how it was developed over the period of time with a special mention of 'Integra' . Future prospects, advantages and disadvantages of Artificial skin are also presented.

1. Topic:
Artificial Skin
Prepared by:
Sana Qasim
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2.  General skin anatomy
 Developmental history of Artificial skin
 Integra: the first artificial skin
 Composition of Integra
 Working of Integra
 Some Complications
 Epicel skin grafts
 Properties of artificial skin
 Future breakthroughs
 Conclusion
 References
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3. Skin is made up of three layers:
Epidermal layer
It is the outer most layer derived from embryonic ectoderm, is
made up of keratinocytes. Besides keratinocytes, which account
for about 80% of epidermal cells, the epidermis is also
composed of the pigment-producing melanocytes, Merkel cells
which are thought to play a sensory role and specialized
dendritic Langerhans cells, which have an essential role in the
skin immune defense system .
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4. Dermal layer
The underlying dermis is formed of strong connective tissue,
which is rich in collagen and confers the characteristic flexibility
to the skin. It also contains hair follicles, and sweat glands.
Subcutaneous/hypodermal layer
The deeper subcutaneous tissue (hypodermis) is made of fat and
connective tissue.
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6. The term artificial skin is used to describe any material used to
replace or to mimic the dermal and epidermal layers of the skin.
There are a number of different types of artificial skin:
 Epicel skin grafts
 Synthetic products which are designed to act as a support so
that the body can grow its own skin as it heals such as:
Integra® Dermal Regeneration Template (Integra Template)
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7.  1442, Italy: An allogenous skin graft was performed.
 1823, Germany: Full thickness autologous skin grafts were
successfully performed by Bunger. Done by transplanting skin
from the patient’s thigh to their nose.
 1875, Scotland: Full-thickness skin grafts become an official
clinical practice.
 1979, United States: Burke and Yannas successfully test the
first artificial skin (Integra) on a patient.
 2002, United States: Integra is FDA approved for treatment of
severe burns
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8. First successful artificial skin produced by Professor Ioannis
Yannis of MIT and Doctor John Burke of Harvard in 1979.
It was patented and now manufactured as “Integra” the artificial
skin
 It is widely used on patients with severe and extensive burns
 For treatment of chronic skin wounds commonly suffered by
people with diabetes, and
 For some types of plastic surgery
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9. Integra® Dermal Regeneration Template (Integra Template) has
two layers:
 A thin outer layer of silicone
 A thick inner matrix layer of pure bovine collagen and
glycosaminoglycan (GAG).
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10. Silastic
Membrane
Integra
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11. Day 0:Pre-treatment
The burn injury or scar contracture is assessed and evaluated
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12. Day 1:Excision
The wound is cleaned and the damaged tissue or contracture scar
is completely excised (removed) down to viable tissue in
preparation for the application of the INTEGRA® Template
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13. Day 1: Application: INTEGRA® Template is applied to the
excised wound bed. Fluids invade the matrix within minutes of
application, adhering it to the wound.
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14. Day 7-14: Neodermal Formation: Fibroblasts and
macrophages migrate into the matrix. Later, endothelial cells
begin forming the neovascular network. As healing progresses,
endogenous collagen is deposited by the fibroblasts, replacing
the collagen/ glycosaminoglycan layer of Integra template.
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15. Day 21+: Complete Neodermal Formation and Silicone
Removal: When the neodermis has formed and vascularization
is adequate, the silicone layer is removed.
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16. Day 21+: Epidermal auto graft: A thin (approximately 0.004”–
0.006”) epidermal auto graft (sheet or meshed and expanded) is
applied over the neodermis.
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17. Day 28-56: Regenerated Skin: Engraftment and wound closure
is complete. Neovascularization is well established.
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19.  Immediate physiological wound closure
 The permanent regeneration of dermal skin
 Thinner skin grafts resulting in less scarring at the donor site
 Faster healing donor sites
 Donor sites can be harvested more frequently
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20.  Loss of Integra due to a hematoma under graft
 Silastic sometimes loosens at edges 2 to 3 weeks after
placement In areas of wear or motion caused by joint
movement.
 Infection can occur in the graft bed under Integra
 Use of Integra template is contraindicated in patients with
hypersensitivity to bovine collagen.
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21. Epicel is made from your own cells after they have grown for a
period of time in an incubator. The Epicel graft replaces the
epidermal or top layer of the skin which is required to close the
wounds.
Epicel is a product that can provide permanent skin replacement
for burn victims, and is made from a patient's own skin cells.
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22.  Alternatives to animal testing and regulations
 Photo aging model
 Pharmacological applications
 Skin disorders and clinical applications
 Cosmetic Uses of Artificial Skin
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23.  Facilitate rapid migration of fibroblasts and micro vascular
cells (neodermis synthesis)
 Controlled rate of biodegradation
 Low/no antigenicity
 Prevent scar formation and contracture
 Infection prevention
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24.  Epidermal portion impermeable to bacteria
 Moderate fluid flux
 Tear strength
 Stable handling and suturing characteristics
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25.  Wound Closure
 Availability in large quantities
 Long shelf life
 Increases survival after serious third degree burns
 Bacterial defense
 Ease of application and removal
 Higher success rate than skin grafting
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26.  Can be expensive
 Allergic reaction to artificial compound
 Lack of skin appendages
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27.  Artificial skin results are promising hence more methods and
products being designed to eliminate need for skin grafting and
full skin restoration. The latest breakthroughs in artificial skin
point to full skin replacements(epidermis, dermis and even
blood vessels)grown entirely in the lab.
 Scientists hope to produce a fully-functional, lab-produced
artificial skin graft in the near future.
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28. The artificial skin requires the use of Wharton's jelly
mesenchymal stem cells. As the name implies, Wharton’s jelly is
a gelatinous tissue in the umbilical cord that contains
mesenchymal stem cells (MSC). The MSC is then combined
with agarose (a polysaccharide polymer) and fibrin (the fibrous
protein that aids in blood clotting).
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29. This yielded two results: skin and the mucosal lining of the
mouth. The researchers are very pleased to have found two new
uses for the stem cells of Wharton’s jelly, which have not
previously been researched for epithelial applications.
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30. Indeed artificial skin is a very helpful invention for medical
science and it will improve to make life easier for the
unfortunate people who need this treatment. Artificial skin is still
a new invention and its medical attention will grow. These skin
reconstructs are becoming robust and have been validated for
many applications.
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31.  Artificial Skin in Perspective: Concepts and Applications
 Generation of an artificial skin construct containing a non
degradable fiber mesh: a potential transcutaneous interface
 Geldhard, Katie. "Artificial Skin." Open Wetware, 18 Jan.
2013.Web.19Oct.2013.
http://openwetware.org/wiki/Artificial_Skin,_by_Katie_Geldrt
 American Burn Association Burn Treatment Facts." The
University of New Mexico, 2013. Web. 19 Oct. 2013.
http://hospitals.unm.edu/burn/facts.shtml
 Dr. John F. Burke, Created Synthetic Skin By Paul
VitelloNov.5,2011
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