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March 1998

New Skin for Old: Developments in Biological Skin Substitutes

Arch Dermatol. 1998;134(3):344-349. doi:10.1001/archderm.134.3.344

SINCE 1988, when the status of cultured skin grafts was reviewed in the ARCHIVES,1 there have been exciting developments in the search for a biological product that can mimic the structure and function of skin. Many skin substitutes have undergone extensive clinical trials; some have been approved by the Food and Drug Administration (FDA) and many are currently undergoing FDA review. In this issue of the ARCHIVES, Falanga et al2 report on the results of a pivotal clinical trial using human skin equivalent (HSE) (Apligraf, Organogenesis Inc, Canton, Mass) in the treatment of chronic venous ulcers. This article reviews the following areas: (1) What skin substitutes are available and how does HSE compare with them? (2) How do the results of this study compare with the standard of care for venous ulcers? (3) What are the risks and benefits of treatment with biological skin substitutes? (4) What are the possible mechanisms of action of these biological agents? (5) How will these products be used in clinical practice?