Skin wounds’ healing basic problems and the use of skin substitutes

Kin substitutes present a heterogenous group of substances that aid in temporary or permanent covering of wounds of various types. Although they can not replace surgical debridement or standard methods of treatment they proffer an alternative to standard methods of treatment whenever the latter are ineffective. Skin substitutes require less wound vascularization, they increase the wound’s cutaneous component, decrease or eliminate inhibitory factors, decrease inflammatory process and grant quick and safe wound closing. Mast cells besides regulating vascular reactions in trauma zone also boost immune, defensive and reparative processes in the wound. Stimulatory influence of mast cells upon fibrosis depend on activation of fibroblasts rather than direct collagen production by mast cells. Attention is focused at studies of autologous adult stem-cells’ stimulation in various organs and tissues as well as at intercellular matrix (ICM). ICM besides being cells’ fastening substrate also controls proliferation, differentiation, migration, apoptosis cells’ functions. Collagen, fibronectin, laminin, proteoglycanes, cytokines and chemokynes are important ICM components. Microcirculation plays a substantial role in wound healing process. Cultivated fibroblasts due to their ability for long-term synthesis of ICM components can effectively correct wound healing process. Allogenic fibroblasts can be successfully used as skin substitutes’ components in the treatment of skin wounds and burns. Unlike autologous fibroblasts the allogenic cells may be obtained in advance and freeze-stored in large quantities.