Engineering Skin for Wound Repair and Regeneration

Skin tissue engineering requires a multidisciplinary effort, reflecting the complexity of the organ that it attempts to replace after loss due to injury, trauma or as a consequence of diseases. Skin substitution aims to achieve complete closure of the existing defect and restoration of the normal function of the tissue. The major challenge faced whilst attempting to achieve such outcomes is successfully recapitulating the complex biology, chemistry and mechanical environments within native skin. Although major advances have been made to include biological entities (cells, biomolecules, small molecules) into engineered substrates to promote biological responses, the role that the substrate itself provides is often overlooked. In this chapter, we consider what might be required so that successful skin substitution post-trauma can be routinely achieved. This will require that researchers from different disciplines collaborate to ensure that not only should the cell types and matrices be carefully chosen, but in parallel, the resultant mechanical parameters need to be considered in the design process. We postulate that an engineering approach is required to recapitulate the skin by driving native healing pathways, ultimately creating a system where the synergistic effects are greater than simply the sum of its parts; where each partial component reflects various aspects of the human biology (cells, annexal structures, etc.), chemistry (materials, gradients, etc.) and physics (mechanics, etc.).