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Artificial Skin
Andre Dienner, Sean Bradley
Department of Journalism, Temple University, Philadelphia, PA 19122

Abstract
This paper will discuss artificial skin and the developments made in the field of tissue
engineering throughout the years. It will discuss Integra which is the first and only FDA
approved product that deals with burn victims, as well as products that may emerge in the future
to help burn victims deal with burns more quickly and efficiently. It also goes through a brief
history of artificial skin that discusses its structure and other vital information involved in tissue
engineering. The paper goes over some applications of artificial skin and discusses briefly the
societal and ethical implications of artificial skin. Scientific and engineering research over the
years really proves to be worthwhile showing with the results of artificial skin in burn victims
and skin reconstruction. The advancements in artificial skin allow burn patients to have hope of
almost full recovery, hope that did not exist nearly a decade ago.

Introduction
The skin, composed of two layers called the dermis and the epidermis, serves several
critical functions for the body. Keeping disease out of the body, releasing waste products and
liquids that are already in the body, and helping to maintain the bodies temperature are just a few
of the many critical functions that the skin serves as a keeper of. The human bodies skin is in
itself very durable and resilient, but because of the skins high exposure and vulnerability to
external factors due to its location on the body, it is easily subjected to damage. Burns, cuts,
scarring, sun damage, and aging are some of the top causes that lead to unpleasant or

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dysfunctional skin. To combat these handicaps, scientists have been working to find a way to
remove damaged skin and replace it with a new skin that will continue to function and blend in
with the original appearance and function. The skins complex architecture and functionality
make it difficult to match, not to mention the additional challenge of varying skin color. However
difficult, artificial skin is an important and essential technology to todays society. The ability to
copy the skins functionality in an aesthetically pleasing way is becoming a rising demand.
Scientists are meeting the rising demand with new advancements and ideas that make artificial
skin look like a promising solution to burns, scars, and aging, among many other causes of need
for artificial skin. With these recent advancements, the challenges of artificial skin such as
coloring problems and a suitable material are being efficiently solved.

Body
History
A sufficient replacement for damaged skin has long been a highly valued and sought after
technology. Up until the end of the twentieth century, the majority of skin replacements were
only able to be performed using autografts, and also some allografts. An autograft is a piece of
tissue moved from one part of one persons own body to another part of the same persons body.
The process of healing a burn victim involves autografts and is decribed as such, Wound care
involves removing dead tissue, preventing infection by applying antibiotics, and replacing the
skin if indicated; the skin may be temporarily replaced by allografts, xenografts, or synthetic
membranes or permanently replaced by autografts. (Wachtel) The problem with autografts was
that patients who had been severely burned and needed skin the most desperately were unable to
be treated, because of the inability to use other areas of skin. If a patient had been so severely
burned that they were unable to use an autograft, the doctors also could attempt to use an

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allograft. An allograft is a piece of tissue from a member of the same species but not the same
specific person. So if the patient could find a suitable donor, the allograft could be attempted.
The problem with an allograft skin implant is that the bodies immune system fights off skin
implants more harshly than any other organ implant. It is very difficult to successfully implement
a skin allograft. If the body attempted to fight off the allograft, infection could occur and the
attempt would fail.
Towards the end of the twentieth century, as organ donations dwindled and tissue
engineering fields began to fluctuate, scientists began to investigate the possibility of genetically
engineering artificial skin in laboratories. Scientists began to culture human skin cells to
implement into damaged skin using scaffolding, and investigating the possibility of
implementing the new technologies for use for human skin. Another source of new skin cells is
from newborns. The source of cells is fibroblasts and keratinocytes isolated from human
foreskin obtained from circumcised newborns. These cells have enormous proliferative potential
and are readily available. (Stephen) Modern products and procedures, such as Apligraf, Botox,
and Laviv, also started taking surface towards the beginning of the two thousands. These
products work to introduce cells and other elements to help the skin grow, repair, or simply
appear cleaner. Apligraf specifically focuses on leg and foot diabetic ulcers. Apligraf is an
ointment that uses living cell therapy to repair and heal the skin to remove the ulcer. Botox is an
injection that helps clear up facial acne and is becoming a very popular treatment. Laviv is a
procedure where a small portion of skin is removed from behind the patients ear, and then the
fibroblast cells from that portion of skin are then extracted. The cells are then injected back into
the area of skin the patient needs work on. Skin care and anti-aging lotions soon after became
common household items and very easily attainable. These lotions work by replenishing collagen

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through topical application in order to slow down skin aging. Lotion containing collagen and
other vitamins essential to the skin is applied to the top of the skin and makes its way through the
epidermis and to the dermis to replenish and supplement the bodies supply.

Description
Integra dermal regeneration template is the first and only FDA approved product that
deals with artificial skin and burn reconstructive surgery. Integra dermal regeneration template is
a two-layer skin regeneration system. The one layer is made up of silicone film. This is the outer
layer, which acts as the epidermis by protecting the body from infection. It also helps to regulate
the bodys temperature. The inner layer is made up of complex matrix of cross-linked fibers. The
inner layer is basically the scaffold, because its porous material allows for regenerating dermal
skin cells. These newly generated dermal skin cells allows for the regrowth of a healthy dermal
layer of skin that is essential for skin recovery. Once the dermal layer is completely regenerated,
the outer layer composed of silicone is then replaced. The silicone is now replaced with
epidermal skin graft, which basically is the skin of the patient that has been growing in the
laboratory for a few weeks while Integra was being used as a substitute. After the patients own
skin cells have replaced the outer layer, then new flexible growing skin emerges when it is all
healed. Some major benefits of Integra are permanent regeneration of dermal skin, faster healing
donor sites, patients can begin rehabilitation wile Integra template is in place, no reports of
rejection, along with many others. (Integra)
In 1996 Integra was approved and introduced for life threatening burn injuries. Since
then, nearly 10,000 patients have been successfully treated using the Integra Template. (Integra)
Integra is used on burn victims when there is not enough autograph available, meaning not
enough of the persons healthy skin left to cover the burned skin. It is also sometimes used due to

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certain patients physiological condition. Integra dermal regeneration template is also used
during reconstruction when other therapies tried on a patient all seem to fail. Integra is not a
solution to curing burn victims but it is extremely helpful to speed the process of recovery.
The complications that have been seen through case studies are similar to those of
autographs that consist of mainly infections. A case study assessing how well Integra works on
burns on and around human hands was taken, and the results were all positive. The article
summed up the results by explaining, this study showed a low complication rate, with a high
percentage of engraftment of thin skin, and good cosmetic and functional quality. The thickness
and viscoelasticity of the skin treated with Integra in our series appeared to be similar to those
of healthy skin. (Danin) The article goes on to discuss the individual results of the patients and
the author makes an interesting statement. They wrote, Integra artificial skin is an attractive
alternative in the treatment of deep burns of the hand and can achieve results with aesthetic and
functional characteristics that are close to those of healthy skin. It sounds great but they only
say close. Scientist and engineers alike are working hard on producing more efficient products to
help burn victims. They want to change the close to exactly like healthy skin. Integra is
presently the only FDA approved product with focus to skin engineering, but there is hope of
more to come that will be even more efficient to burn victims.

Application
Artificial skin is useful for many applications. As the skin is the outermost located organ
in the body and is constantly exposed to the environment and other objects, it is the most easily
damaged organ the body has. Cuts and bruises are commonplace injuries that are unavoidable in
humans everyday life. Some are small and trivial and go away in a matter of days, while some
can be traumatizing and very serious. When a serious cut or bruise occurs, the stakes are raised

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much higher and things must be taken more seriously. The injured area can become severely
infected if not taken care of properly, and permanent scarring often occurs. This can lead to
embarrassment for years to come because of how unappealing and ugly scars can become. For a
patient to be able to replace damaged skin with artificial skin or other healthy skin, it can
positively affect the rest of their lives because of the restored confidence and saving of their
appearance.
Artificial skin also is useful for the application of replacing skin damaged by the sun. As
skin is constantly exposed to rays of light, the sun can take a serious toll on the appearance and
functionality of the skin. If not taken seriously sun damage can go as far as causing skin cancer.
When a patient has skin that has been severely affected due to years of troubles with sun damage
and effects, artificial skin can be applied to restore the healthy appearance and necessary
functions of the patients skin. As sun damage becomes an increasing danger and rising cause of
skin cancer in todays society, this is becoming a key function for artificial skin.
Another application of artificial skin is for burn victims. Burns can result in a variety of
effects on the body. Severe blisters can occur, pigmentation of the skin can be destroyed, the
functionality of portions of the skin can be ruined, and many other damages can occur that the
human body cannot properly or fully operate with. Artificial skin can be applied to burn victims,
even if the burn victim has no skin fit to perform an autograft. Artificial skin can repair and
replenish skin that otherwise would be permanently dysfunctional and aesthetically unpleasing
for the patient.
Yet another application for artificial skin is for aging bodies. As the body ages, it results
in the skin gradually losing collagen, which results in wrinkly, dry, and generally displeasing skin
for the patient. If the skin becomes severely unpleasant or if the skin starts to not be able to serve

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its necessary function, artificial skin can be used to replace it. Even though it is an accepted fact
that age results in worse skin, artificial skin can help to replace skin that becomes so brittle and
dry that it starts to present a health risk for the patient.

Future of The Technology

Advancements
A major recent advancement that has come about in the artificial skin field of technology
is Jorge Gerlachs Skin Gun. The skin Gun is still in testing and not widely used yet, but it has
been used and successfully treated a select few patients who were operated on. The Skin Gun
works by spraying stem cells onto the injured area of the body which then combine with the
original skin to restore the patients skin appearance and functionality. Because of the need for the
stem cells to attach to skin that is already present on the patient, this method has been proven to
only be able to work on second-degree burn victims. With third degree burn victims, there are no
external cells for the stem cells to attach to and therefore the treatment does not take effect.
This new idea, along with the recent advancements being made in stem cell research and
tissue engineering, causes me to believe that there is a promising future ahead for artificial skin.
As debate over stem cell research and collection continues, it is clear that the decisions made
regarding stem cell research will have a huge impact on the progress of this area of technology. If
stem cell research is deemed unethical and steps are taken to scale it back, it can be assumed that
artificial skin progress will be significantly slowed. If steps are taken to advance stem cell
research and more opportunities to advance are set in place, artificial skin progress will
undoubtedly benefit greatly. In my opinion stem cell research is an appropriate scientific action,
and I believe it will soon be used to increase tissue engineering in every aspect, especially
artificial skin.

Societal and Ethical Implications

There has been really no concern about societal or ethical implications as far as artificial
skin is concerned. Artificial skin is relatively cheap and its accessibility is high for burn victims
and patients looking for skin reconstruction. The only thing that would be expensive would be
the skin gun. Since it is not yet FDA approved there is no set price for the gun but the cost is
predicted to be high. If it were to be approved then there would be questions raised to the
availability it would have for burn victims, but as of right now there are very little concerns
economically with artificial skin. Since tissue-engineering deals with the patients own skin cells
being reproduces in laboratories the availability is no concern. The only concern is the time it
takes to produce the new skin cells.

Conclusion
From the very beginning of research of artificial skin to the products that have been
created today, much improvement has been made in the field of artificial skin. Although some
burn victims and patients seeking skin reconstruction have seen some amazing results, others still
struggle with skin damage and deformation. With new products such as Jorge Gerlachs Skin
Gun, there is no doubt artificial skin will continue to see success in the future. Hopefully in the
near future scientist and engineers will be able to perfect artificial skin, but regardless they have
come along way and continue to help save peoples skin.

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References
Antonia E. Stephen, Joseph P. Vacanti, "Tissue engineering," in AccessScience, McGraw-Hill
Companies, 2001, http://www.accessscience.com.libproxy.temple.edu

Aurlie Danin, Gabriella Georgesco, Anne Le Touze, Alexandre Penaud, Richard Quignon,
Gilbert Zakine, Assessment of burned hands reconstructed with Integra by
ultrasonography and elastometry, Burns, Volume 38, Issue 7, November 2012, Pages 9981004, ISSN 0305-4179, 10.1016/j.burns.2012.02.017.

INTEGRA Dermal Regenerqation Template - Introduction." INTEGRA Dermal

Regenerqation Template. N.p., n.d. Web. 12 Nov. 2012.
<http://www.ilstraining.com/idrt/introduction.html>.

Thomas L. Wachtel, "Burn," in AccessScience, McGraw-Hill Companies, 2012,

http://www.accessscience.com.libproxy.temple.edu