Skin tissue engineering and keratinocyte stem cell therapy

In pathologies where there is large skin loss and damage such as burns and chronic ulcers, successful treatment is dependent on prompt excision followed by early wound coverage to increase survival rates. The field of skin engineering for the treatment of such acute and chronic wounds has expanded over the last three decades due to increased knowledge gained and technical advances in the areas of molecular and cellular biology. This chapter focuses on skin biology, wound healing, keratinocyte culture, and grafting, the latter of which has led to the generation of epidermal replacements and the need for a dermal layer for permanent wound closure. Subsequently, the development of dermal template products and cultured skin substitutes are discussed with emphasis being placed on their biological relevance to wound healing. The clinical application of keratinocyte stem cells and the potential use of other adult stem cells in skin tissue engineering are also discussed.