Our skin is more than just a covering—it’s our largest organ and first line of defense against the world around us. When skin is damaged through injury, disease, or genetic conditions, the consequences can be serious and even life-threatening. Traditional wound care approaches often fall short, especially for large wounds or those that won’t heal.

That’s where bioengineered skin substitutes come in—innovative products that are changing the game in wound management and tissue engineering. These substitutes aim to mimic real skin, providing a framework for cells to migrate, helping tissue to regenerate, and speeding up the healing process. From treating stubborn diabetic ulcers to covering severe burn injuries, these technologies are transforming outcomes for patients and opening new opportunities in the healthcare market.

Right now, we’ll explore the exciting world of bioengineered skin substitutes—where they came from, how they work, who’s using them, and where the industry is headed next.

The Journey: How Skin Substitutes Evolved

The story of modern skin substitutes began in the mid-20th century when doctors and researchers recognized the limitations of traditional skin grafts. While taking skin from one part of a patient’s body to cover wounds elsewhere (autografts) remains the gold standard, this approach has obvious drawbacks: limited donor skin, additional surgical wounds, and potential complications.

A breakthrough came in the late 1970s when Dr. Howard Green and his team at Harvard Medical School developed the first cultured epidermal autograft (CEA). They showed that skin cells (keratinocytes) from a small biopsy could be grown in the lab to cover large wound areas. This technique was first used in 1981 to treat two severely burned patients, marking a turning point in regenerative medicine (Green et al., 1979; O’Connor et al., 1981).

The market really took off in the 1980s and 1990s with advances in biomaterials and tissue engineering. A milestone came in 1998 when Apligraf (made by Organogenesis Inc.) became the first FDA-approved skin substitute containing living cells. Since then, the field has exploded, with dozens of products entering the market, each offering unique benefits for different types of wounds.

Types of Skin Substitutes: Understanding Your Options

Skin substitutes come in many forms, each designed for specific clinical needs. Let’s break down the main categories:

Based on Cellular Content

Acellular products contain no living cells—just the structural framework (extracellular matrix) that supports cell growth. Think of these as sophisticated scaffolds that your body can populate with its own cells. Products like AlloDerm, Integra, and Oasis fall into this category.

These products are generally easier to store, have longer shelf lives, and often come with fewer regulatory hurdles. For healthcare facilities, this means simpler inventory management and potentially lower costs. For patients, they offer effective wound coverage without the complexity of living tissue maintenance.

Cellular products contain living cells such as skin cells (keratinocytes), connective tissue cells (fibroblasts), or regenerative stem cells. Examples include Apligraf, Dermagraft, and StrataGraft.

These living substitutes can actively participate in the wound healing process, releasing growth factors and creating new tissue. While they’re typically more complex to produce and store—often requiring special shipping conditions and having shorter shelf lives—they can offer superior results for certain difficult-to-heal wounds.

Based on Where They Come From

Allogeneic products come from human donors (not the patient). They offer the advantage of immediate availability without requiring a harvest procedure from the patient.

Xenogeneic products are derived from animal sources—usually pig (porcine) or cow (bovine) tissues that have been processed to remove components that might trigger rejection. These products leverage the natural similarity between human and animal tissues while providing abundant source material.

Synthetic products are created from non-biological materials like polymers. They offer consistent quality, no disease transmission risk, and typically longer shelf life.

Composite products combine elements from different sources to get the best of each. This approach allows manufacturers to optimize different aspects of the substitute—perhaps using synthetic materials for strength while incorporating biological elements for better tissue integration.

Based on Skin Layer Replaced

Epidermal substitutes replace only the outer layer of skin (epidermis). They’re thinner and typically used for superficial wounds.

Dermal substitutes replace the deeper skin layer (dermis). They provide the structural support needed for the body to rebuild a functional outer layer.

Dermo-epidermal (composite) substitutes mimic both layers of skin, offering a more complete replacement. These are often used for full-thickness wounds where both skin layers are damaged.

The Building Blocks: What Makes a Good Skin Substitute

Creating effective skin substitutes isn’t just about combining ingredients—it’s about engineering products that work harmoniously with the body’s own healing processes. 

Here’s what goes into making these advanced products:

The Cell Team: Different Players for Different Roles

Cells are the workhorses in living skin substitutes. Different cell types have specific jobs:

Keratinocytes form the protective outer layer of skin, creating the barrier that keeps moisture in and harmful substances out. In skin substitutes, these cells help close the wound and restore that crucial barrier function. For patients with large burns, having these cells ready to deploy can literally be lifesaving.

Fibroblasts are the construction workers of skin, producing the structural proteins and chemical signals that rebuild damaged tissue. They create collagen (skin’s main structural protein) and release growth factors that coordinate the healing process. When included in skin substitutes, these cells jumpstart the repair process, particularly valuable in chronic wounds where the natural healing process has stalled.

Endothelial cells form blood vessels, crucial for bringing nutrients and oxygen to healing tissue. Without good blood supply, even the best skin substitute will fail. Some advanced products include these cells to promote faster vascularization (blood vessel formation).

Stem cells are the body’s master cells, capable of developing into different cell types as needed. Recent research has explored using induced pluripotent stem cells (iPSCs) and mesenchymal stem cells (MSCs) in skin substitutes. A study by Shi et al. (2020) found that scaffolds containing MSCs significantly improved healing rates in diabetic wounds compared to products without cells.

The Structural Framework: Supporting Cell Growth

The extracellular matrix (ECM) is the natural scaffold that supports cells in healthy skin. Key components include:

Collagen is the most abundant protein in skin, providing strength and structure. Think of it as the skin’s framing—without it, new tissue would lack integrity. Various types of collagen are used in skin substitutes, with type I being most common.

Elastin gives skin its ability to stretch and bounce back—crucial for areas like joints where flexibility matters. Skin substitutes that incorporate elastin offer better mechanical properties and more natural movement.

Glycosaminoglycans (GAGs) like hyaluronic acid help skin retain moisture and bind growth factors. In skin substitutes, these molecules create a hydrated environment that supports cell migration and proliferation. For chronic wounds that tend to be dry, these moisture-retaining components can make a significant difference.

Fibronectin and laminin help cells attach to surfaces and navigate during wound healing. These proteins act like cellular GPS systems, guiding cells to where they need to go in the healing wound.

The Scaffold: A Home for New Tissue

Biomaterial scaffolds provide the three-dimensional structure that supports cell attachment and organization. 

The ideal scaffold should be:

Biocompatible to avoid triggering immune rejection or inflammation. For patients already dealing with wounds, the last thing they need is their body fighting the treatment.

Biodegradable at a rate that matches new tissue formation. A good scaffold gradually dissolves as your own tissue takes over—not too fast (which would leave new tissue unsupported) and not too slow (which could impede complete healing).

Porous enough to allow cells to move in and nutrients to flow through. Without adequate porosity, cells can’t populate the scaffold, and new blood vessels can’t form.

Mechanically suitable to match the properties of the skin it’s replacing. Skin on your elbow needs different mechanical properties than skin on your thigh, and advanced products are beginning to address these nuances.

Growth Factors: The Chemical Messengers

Bioactive molecules can supercharge the healing process. Key factors used in advanced skin substitutes include:

Epidermal growth factor (EGF) stimulates skin cells to multiply and migrate, helping close the wound surface. For large wounds, this acceleration of surface closure can significantly reduce infection risk.

Vascular endothelial growth factor (VEGF) promotes the formation of new blood vessels. Without adequate blood supply, even the most sophisticated skin substitute will fail—making VEGF a critical component for success.

Platelet-derived growth factor (PDGF) enhances the growth of structural cells and has been shown to improve healing in diabetic foot ulcers. In fact, PDGF was the first growth factor approved by the FDA specifically for wound healing.

Basic fibroblast growth factor (bFGF) supports overall tissue regeneration, affecting multiple cell types involved in the healing process.

Transforming growth factor-β (TGF-β) regulates ECM production and can both promote and regulate scarring, depending on context and timing.

Products in the Market: Options for Different Needs

Let’s look at some of the leading products currently available:

Epidermal Substitutes

1. Epicel (Vericel Corporation)

This cultured epidermal autograft uses the patient’s own skin cells, expanded in the lab to cover large areas. It’s primarily used for severe burns covering a large percentage of the body when donor sites for traditional grafts are limited. While it provides permanent coverage, it does have limitations: it’s fragile, lacks the supportive dermal layer, and comes with a high price tag—often over $10,000 per 1% of body surface area covered.

2. EpiCord (MiMedx)

Derived from human umbilical cord, EpiCord provides a rich source of growth factors and ECM proteins. The product comes dehydrated, making it easier to store and handle in clinical settings. It’s particularly useful for chronic wounds like diabetic foot ulcers, where it provides both physical coverage and biochemical signals that stimulate healing.

Dermal Substitutes

1. Integra Dermal Regeneration Template (Integra LifeSciences)

As the first FDA-approved skin substitute (1996), Integra has established a strong track record. It consists of two layers: a temporary silicone outer layer that acts as a barrier, and an inner layer made of bovine collagen and glycosaminoglycans that serves as a scaffold for dermal regeneration. 

Once the dermal layer becomes vascularized (typically 2-3 weeks), the silicone layer is removed and replaced with a thin autograft or epidermal substitute. This approach has revolutionized burn care, allowing surgeons to cover large areas with minimal donor skin.

2. AlloDerm (Allergan)

AlloDerm is made from human cadaveric skin that’s been processed to remove cells while preserving the natural dermal structure. This acellular dermal matrix provides an excellent scaffold for the patient’s own cells to populate. Beyond burns, it’s found applications in breast reconstruction, hernia repair, and other soft tissue procedures, making it one of the most versatile skin substitutes on the market.

3. Oasis Wound Matrix (Smith & Nephew)

Derived from pig small intestine, Oasis provides a rich natural scaffold containing collagen, growth factors, and glycosaminoglycans. Available as an off-the-shelf solution, it’s particularly useful for partial-thickness wounds and chronic ulcers. Its relative affordability compared to some other options has helped drive its adoption in wound care centers.

Composite (Dermo-Epidermal) Substitutes

1. Apligraf (Organogenesis Inc.)

This bilayered living skin construct contains newborn foreskin fibroblasts in a collagen matrix (dermal layer) topped with newborn keratinocytes (epidermal layer). Though it doesn’t permanently integrate (eventually being replaced by the patient’s tissue), it provides active biological signals that jump-start healing in stalled wounds. 

FDA-approved for diabetic foot ulcers and venous leg ulcers, Apligraf has demonstrated impressive clinical results. A pivotal study by Veves et al. (2001) showed that 56% of diabetic foot ulcers treated with Apligraf achieved complete closure at 12 weeks, compared to only 38% with standard care.

2. OrCel (Ortec International)

This bilayered product uses bovine collagen containing allogeneic fibroblasts and keratinocytes. It’s particularly useful for managing donor sites in burn patients and treating painful wounds associated with recessive dystrophic epidermolysis bullosa, a rare genetic skin disorder.

3. StrataGraft (Stratatech/Mallinckrodt)

One of the newer entrants to the market (FDA-approved in 2021), StrataGraft uses proprietary NIKS cells (Near-diploid Immortalized Keratinocyte S) to create a full-thickness skin substitute that closely resembles natural skin both structurally and functionally. It’s currently approved for treating thermal burns that would typically require skin grafting.

4. TheraSkin (Soluble Systems)

This human skin allograft is derived from donated human skin and contains living cells, growth factors, and native collagen. It provides both immediate wound coverage and biological signals to stimulate healing in challenging wounds like diabetic foot ulcers and venous leg ulcers.

Real-World Applications: Where These Products Make a Difference

Bioengineered skin substitutes are making an impact across multiple medical specialties:

Transforming Burn Care

Severe burns represent one of the most challenging scenarios in medicine. Before bioengineered substitutes, patients with burns covering large portions of their body faced limited options and poor outcomes. Today, these products are:

Providing immediate wound coverage to prevent fluid loss and infection—critical factors in severe burn cases where the skin’s barrier function is compromised across large areas. For burn unit directors, having these products on hand can mean the difference between life and death for patients with extensive injuries.

Reducing the need for extensive autografting, which is particularly important for severely burned patients who have limited uninjured skin available for harvesting. This means less surgical trauma and faster overall recovery.

Improving both functional and aesthetic outcomes. A landmark study by Heimbach et al. (2003) showed that patients treated with Integra followed by thin epidermal autografts had better long-term function and less scarring compared to conventional approaches.

Tackling the Chronic Wound Crisis

With an aging population and rising rates of diabetes, chronic wounds have become a major healthcare challenge—and expense. Annual costs for treating chronic wounds in the U.S. alone exceed $25 billion. These wounds include:

Diabetic foot ulcers, which affect approximately 15% of diabetes patients during their lifetime and precede 85% of diabetes-related amputations. Bioengineered skin substitutes have shown remarkable success in healing these notoriously difficult wounds, potentially reducing amputation rates and their associated costs and quality-of-life impacts.

Venous leg ulcers, affecting about 1% of adults and 3.6% of people over 65. These painful, persistent wounds often respond well to advanced skin substitutes when conventional treatments have failed.

Pressure ulcers (bedsores), which develop in approximately 2.5 million patients in U.S. acute care facilities annually. These wounds are particularly challenging in immobile and elderly patients, and advanced skin substitutes offer new hope for faster healing.

For wound care clinics and hospital administrators, the initially higher cost of these advanced products is increasingly justified by their ability to heal wounds faster, reduce complications, and minimize hospitalization time.

Expanding Options in Reconstructive Surgery

In reconstructive procedures, skin substitutes are:

Providing coverage for complex defects where traditional approaches fall short, such as in cases following tumor removal or trauma. The versatility of these products gives surgeons new options for challenging cases.

Reducing donor site morbidity by minimizing the amount of the patient’s own skin needed—a significant benefit in patients with limited donor sites or those who cannot tolerate additional surgical wounds.

Improving both functional and aesthetic outcomes. For plastic surgeons, this means better results and higher patient satisfaction.

New Hope for Genetic Skin Disorders

For patients with devastating genetic skin disorders such as epidermolysis bullosa (EB)—often called “butterfly skin” because of its extreme fragility—bioengineered skin combined with gene therapy offers unprecedented hope.

In a groundbreaking case reported by Hirsch et al. (2017), researchers successfully treated a patient with junctional EB by taking the patient’s own skin cells, correcting the genetic defect, growing them into sheets, and grafting them back onto wounded areas. This approach demonstrates the potential for combining genetic modification with tissue engineering to address previously untreatable conditions.

Hurdles to Overcome: Challenges in the Field

Despite remarkable progress, several challenges remain:

The Blood Supply Problem

Without blood vessels, thick engineered tissues can’t survive. Current approaches include:

Incorporating growth factors like VEGF to stimulate the patient’s body to grow blood vessels into the substitute. This works, but takes time—and time is something that exposed wounds don’t have in abundance.

Developing pre-vascularized constructs that already contain a network of vessel-forming cells. These more complex products aim to connect with the patient’s circulation more quickly.

Using scaffold designs with specific patterns or channels that guide blood vessel growth. Some new materials feature microchannels that serve as “highways” for invading blood vessels.

For product developers, solving the vascularization challenge could enable thicker, more functional skin substitutes that better mimic natural skin.

Keeping the Peace with the Immune System

Products containing cells or materials from sources other than the patient may trigger immune responses, affecting long-term integration. Companies are addressing this through:

Advanced decellularization techniques that thoroughly remove immunogenic components while preserving beneficial structural elements. The goal is to provide the benefits of natural tissue without the rejection risk.

Biomaterials with immunomodulatory properties that actively calm the immune response rather than just trying to hide from it. These “stealth” materials represent a more sophisticated approach to biocompatibility.

Autologous approaches that use the patient’s own cells, eliminating rejection concerns but introducing logistical challenges and higher costs.

The Cost Equation

Many advanced skin substitutes remain expensive, limiting their widespread adoption. However, the equation is changing:

Manufacturing innovations are gradually bringing costs down as companies scale production and refine processes. What was once bespoke is becoming more standardized.

A growing body of economic research shows that despite high initial costs, certain bioengineered skin substitutes may reduce overall healthcare expenditures by accelerating healing and reducing complications like infections or amputations. Sood et al. (2023) conducted a comprehensive cost-effectiveness analysis demonstrating that when accounting for total care costs—not just the product price—many advanced substitutes actually save money.

Healthcare systems are increasingly looking at value-based metrics rather than simple product costs, creating opportunities for products that can demonstrate superior overall outcomes and cost-effectiveness.

Making Skin That’s Actually Like Skin

Current skin substitutes often lack important features of natural skin:

Hair follicles not only grow hair but also play crucial roles in wound healing and house stem cell populations that can regenerate skin. Their absence in current substitutes limits both functionality and appearance.

Sweat glands are essential for thermoregulation—without them, patients with large areas of substitute skin may have difficulty regulating body temperature, particularly in hot environments.

Sebaceous glands produce oils that keep skin supple and contribute to its barrier function. Their absence can lead to dry, fragile skin.

Sensory receptors are what allow us to feel touch, temperature, and pain—crucial feedback that helps us navigate our environment safely. Current substitutes lack this sensory function.

For companies developing next-generation products, incorporating these elements represents both a challenge and a major market opportunity.

The Horizon: Where the Field Is Headed

The bioengineered skin substitute field continues to evolve rapidly, with several exciting developments on the horizon:

Printing Skin: The 3D Bioprinting Revolution

Three-dimensional bioprinting allows precise positioning of cells and biomaterials to create complex, multi-layered structures. This technology offers:

Unprecedented control over the spatial arrangement of different cell types, allowing researchers to recreate the complex architecture of natural skin. Imagine placing melanocytes (pigment cells) exactly where they belong or creating precise patterns of dermal papillae for hair follicle development.

The ability to incorporate channels for blood vessels, addressing one of the field’s biggest challenges. Baltazar et al. (2020) demonstrated the feasibility of bioprinting a full-thickness skin model containing both dermal and epidermal components with integrated vascular structures.

Customization for individual patient needs—potentially allowing substitutes to be tailored to specific wound geometries or patient characteristics like skin tone.

For industry watchers, companies developing bioprinting technologies for skin applications represent an exciting investment frontier with applications beyond wound care.

Smart Materials: Skin Substitutes That Adapt

Advanced materials that respond to environmental cues or deliver therapeutics on demand are in development:

Stimuli-responsive polymers that adapt to wound conditions—perhaps becoming more porous when inflammation is detected or releasing anti-inflammatory compounds when needed. These “smart” materials could substantially improve outcomes in complex wounds.

Materials with built-in antimicrobial properties to prevent infection—a major cause of graft failure and wound healing complications. Some approaches incorporate silver or other antimicrobial agents, while others use peptides that specifically target bacterial membranes.

Systems for controlled release of growth factors and drugs, delivering the right signals at the right time during the healing process. This temporal control mimics the natural sequence of healing better than current approaches.

Gene Editing: Correcting the Code

Genetic modification techniques are opening new possibilities:

Correcting genetic defects in patient-derived cells before using them in skin substitutes—a promising approach for treating genetic skin disorders. This combines the best of gene therapy and tissue engineering.

Engineering cells with enhanced regenerative capabilities, such as improved resistance to oxidative stress or increased production of growth factors. These “super cells” could potentially overcome the hostile environment of chronic wounds.

Creating disease models for testing therapeutic approaches. Engineered skin containing cells with specific genetic modifications can serve as testing platforms for new drugs or treatments, potentially accelerating pharmaceutical development.

The Complete Package: Adding Skin Appendages

Research is progressing toward incorporating functional skin appendages:

Hair follicles would provide not just cosmetic benefits but also important regenerative capabilities, as they harbor stem cell populations. For burn survivors and others with large areas of skin replacement, the addition of hair follicles would represent a major quality-of-life improvement.

Sweat glands for thermoregulation would be particularly valuable for patients with large areas of engineered skin, who currently may have difficulty regulating body temperature in hot environments.

Pigmentation systems would provide a more natural appearance, addressing the psychological aspects of recovery. Current substitutes often lack normal pigmentation, creating a stark contrast with surrounding skin.

Lee et al. (2024) reported significant progress in developing bioengineered skin constructs containing rudimentary hair follicles and sebaceous glands, moving the field closer to truly functional skin replacement.

Bringing Back Feeling: The Innervation Challenge

Restoring sensory function remains a significant goal. Emerging approaches include:

Co-culture with neural cells to promote the growth of nerve endings into the substitute. Without sensation, patients can easily injure engineered skin without realizing it.

Incorporation of neurotrophic factors that attract and guide nerve growth from surrounding tissue. These chemical signals can help the body’s own nerves colonize the engineered tissue.

Biomaterial designs with specific microstructures that create pathways for nerve growth, similar to the approaches being developed for vascularization.

Navigating Regulation: Getting Products to Market

Developing and commercializing bioengineered skin substitutes involves complex regulatory considerations:

In the United States, skin substitutes may be regulated by the FDA under different frameworks depending on their characteristics:

Medical devices follow one pathway, while biological products follow another. Combination products that include both device and biological components face particularly complex regulatory reviews.

Human cells, tissues, and cellular and tissue-based products (HCT/Ps) have their own regulatory framework, with requirements varying based on the degree of processing and intended use.

For companies developing new products, understanding these regulatory nuances early in the development process is crucial to avoid costly delays or redesigns. Experienced regulatory affairs professionals are increasingly valuable team members for companies in this space.

Clinical trials must demonstrate not only safety and efficacy but also manufacturing consistency, shelf stability, and appropriate handling characteristics. These requirements add time and cost to development but ensure that products reaching the market are safe and effective.

The regulatory landscape continues to evolve as agencies gain experience with these complex products. Forward-thinking companies maintain close communication with regulatory bodies throughout the development process.

Looking Ahead: The Business Landscape

The bioengineered skin substitute market is projected to reach $5.1 billion globally by 2027, growing at a CAGR of approximately 9.5%. Several factors are driving this growth:

Rising prevalence of chronic wounds due to aging populations and increasing rates of diabetes and obesity. In the U.S. alone, chronic wounds affect 6.5 million patients annually.

Increasing burn incidence, particularly in developing regions with rapid industrialization and less stringent safety regulations.

Growing acceptance of advanced wound care products among clinicians as evidence of their cost-effectiveness accumulates.

Expanding applications beyond wound care into areas like cosmetic testing (as alternatives to animal testing) and drug development platforms.

For investors and industry participants, key trends to watch include:

Consolidation within the industry as larger medical device and pharmaceutical companies acquire innovative startups with promising technologies.

Increased emphasis on cost-effectiveness data to support reimbursement decisions. Products that can demonstrate not just clinical efficacy but also economic benefits will have significant advantages.

Development of more specialized products for specific wound types or patient populations, moving away from the “one-size-fits-all” approach of earlier generations.

Integration of digital technologies for wound assessment and monitoring, potentially creating connected wound care ecosystems that optimize product selection and usage.

Conclusion

Bioengineered skin substitutes represent one of the most successful applications of tissue engineering in clinical practice today. From treating life-threatening burns to healing stubborn chronic wounds, these products have transformed patient care across multiple medical specialties.

The field continues to advance rapidly, with innovations in 3D bioprinting, smart biomaterials, genetic engineering, and appendage development promising even more sophisticated solutions. While challenges remain—particularly in vascularization, sensory function, and cost-effectiveness—the trajectory is clear: bioengineered skin substitutes will continue to evolve, offering new hope to millions of patients worldwide.

For healthcare providers, these products represent powerful new tools in the wound care arsenal. For investors and industry participants, they offer exciting opportunities in a growing market with substantial unmet needs. And for patients suffering from acute wounds, chronic ulcers, or genetic skin disorders, they promise something even more valuable: the chance to heal.

References

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2. Green, H., Kehinde, O., & Thomas, J. (1979). Growth of cultured human epidermal cells into multiple epithelia suitable for grafting. Proceedings of the National Academy of Sciences, 76(11), 5665-5668.

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5. Lee, S., Hwang, C., Kim, J., Han, S., Na, Y., Kim, J., … & Kim, W. S. (2024). Engineering of functional skin containing hair follicles and sebaceous glands. Advanced Science, 11(1), 2302816.

6. O’Connor, N. E., Mulliken, J. B., Banks-Schlegel, S., Kehinde, O., & Green, H. (1981). Grafting of burns with cultured epithelium prepared from autologous epidermal cells. The Lancet, 317(8211), 75-78.

7. Shi, R., Xue, J., Wang, H., Wang, R., Gong, M., Chen, L., … & Guan, G. (2020). Fabrication and evaluation of a homogeneous adipose-derived mesenchymal stem cell sheet scaffold for diabetic wound healing. Journal of Biomedical Materials Research Part A, 108(8), 1563-1574.

8. Sood, A., Granick, M. S., & Tomaselli, N. L. (2023). Comparative cost-effectiveness of advanced wound therapies for chronic wounds: A comprehensive meta-analysis. Advances in Wound Care, 12(3), 120-134.

9. Veves, A., Falanga, V., Armstrong, D. G., & Sabolinski, M. L. (2001). Graftskin, a human skin equivalent, is effective in the management of noninfected neuropathic diabetic foot ulcers: a prospective randomized multicenter clinical trial. Diabetes Care, 24(2), 290-295.