Development of new acellular lyophilized dermal matrices for advanced wound healing

Though a great variety of dermal matrices and skin equivalents are available, either synthetic and semisynthetic, viable human skin allografts are still considered the most physiological alternative to autologous skin in hard-to-heal wounds. Wound closure after post-traumatic injuries and/or localized at peculiar body sites (head-and-neck, oral cavity, lower legs) are particularly challenging and can often be delayed due to local and systemic factors. In these cases, integrated medical-surgical approach based on the use of dermal acellular matrices should be considered. Skin bank are tissue establishments dedicated to the procurement, processing and distribution of human-derived skin bioproducts for clinical purposes. In the Skin Bank of Siena, we developed and validated 4 new different bioproducts based on cadaver skin donation, including: deep-frozen de-epidermized dermis (DED), deep-frozen reticular dermis (DER), lyophilized DED and lyophilized DER. By acting as a physiological scaffold, these products add several advantages, such as significant control of pain and exudate, protection of deep structures (e.g. tendons, bones, cartilage and nerves), stimulation of a functional new dermis (rather than a scar) and re-epithelization with relevant reduction of wound closure time.