This document discusses various types of skin substitutes that can be used as temporary or permanent replacements for skin, including biological, synthetic, and bio-synthetic options. It provides details on human allograft skin, noting that it expresses class-2 antigens and is typically rejected within 2-3 weeks but rejection can be decreased through various treatments. The document also discusses the use of autografts with allografts and shows pictures demonstrating the application and results of using amnion grafts on wounds. It provides an overview of Integra, a bio-synthetic skin substitute, explaining its inner biodegradable membrane and outer silicone layer and how it integrates with the body over time.

1. BY-Nilasish Pani
Guide-Dr. Bibhuti Bhusan Nayak
Associate Professor
Plastic Surgery
SCBMCH

4. Skin Substitutes
Temporary-skin
substitutes
BIOLOGICAL
> Human
allograft
> Xenograft
> Amniotic
membrane
> Collagen
SYNTHETIC
> Duoderm
> Opsite
> Omniderm
BIO-
SYNTHETIC
> Biobrane
> Integra
Permanent-skin
substitutes
> CEA
> ADM
> COMPOSITE
GRAFT

6. Allograft skin
Langerhans cell express class-2 Ag
Graft rejection within 2 to 3 wk
Decrease in graft rejection by- 1) uv irradiation
2)incubation in glucocorticoid
3)immunosuppresion

7. AUTOGRAFT
AUTOGRAFT
+
ALLOGRAFT

12. 7th DayDay of Application
Auto-meshgrafts covered with
amnion during the operation
Appearance at end of treatment
Same case

13. COMMERCIAL
Bovine, Porcine, fish, human
amnion
Sheep(intestine,tendo-achilles)
FOUND IN EXTRACELLULAR MATRIX
20 types (I,III m/c) 25-35%body protein
INSOLUBLE FIBROUS PROTEIN
Chief const of connective tissue Organic sub of bones

14. Features & Properties

16. PRE OP
7TH DAY POST OP
AFTER CLEANING WITH NS
AFTER COLLAGEN APPLICN

19. (INTEGRA)
inner biodegradable
memb. [bovine collagen+
chondroitin SO4]
(dermal component)
Gets vascularised,
Fibroblasts migrate
Outer silicone [temporary]
(epiderm. component)
Protects wound from
desiccation/infection
Removed after 3 wks