Skin Burns and Tissue Engineering

Skin burns are a global public health problem, accounting for an estimated ۱۸۰,۰۰۰ deaths annually worldwide. The process of repairing and regenerating damaged tissue is slow and time-consuming, so external therapeutic agents can be used to speed up this vital process. The most practical method to repair burn lesions is skin grafting, but it can be limited by donor site availability and cause additional pain for the patient. Tissue engineering is a promising approach for developing new solutions for burn repair. Cells are a crucial part of the tissue engineering triangle, and there are two main types of cells used in burn repair: somatic cells and stem cells.Somatic cells are further divided into three groups: autograph, allograph, and xenograft. Autologous cells are preferred in clinical trials because they have a low risk of transplant rejection and tumorigenesis. Stem cells are undifferentiated cells that have the potential to develop into different types of cells. They are particularly important in wound healing because of their ability to self-renew and differentiate.One promising approach to tissue engineering for burn repair is the use of split-thickness skin grafts (STSG). STSG technology allows skin grafts to be expanded to much larger sizes, which can overcome the limitation of donor site availability. Another promising approach is the use of tissue to cell suspension. This technique involves mechanical methods to create a suspension of keratinocytes, melanocytes, fibroblasts, and Langerhans cells, which are then sprayed onto the desired site. This technique helps to speed up the healing of the wound, prevent the creation of excess wound, and disturbance in the pigmentation of the donor area. The use of stem cells is also of particular importance in wound healing. Fat tissue contains cells called Stromal vascular fraction (SVF), which contains heterogeneous stem cells. These cells can be extracted using mechanical and enzymatic techniques and contain mesenchymal stem cells, hematopoietic stem cells, fat and preadipocyte cells, fibroblast cells and immune cells such as macrophages.SVFs cells can secrete pro-angiogenic factors, which induce proliferation of endothelial cells and improve angiogenesis. They also secrete transforming growth factor-۱ (TGF-۱), hepatocyte growth factors (HGF) and interferon-γ (INF-γ), which exert immunomodulatory effects. Another important issue in the topic of burn is mitochondria. Mitochondrial function is impaired in burns. These organelles are involved in many important cellular activities, including energy production, heat regulation, calcium homeostasis, biogenesis and assembly of iron-sulfur proteins, apoptosis control, production of reactive oxygen species (ROS), and cell survival, proliferation, production of metabolites, coordination of metabolic pathways as well as cell signaling. Thermal traumas such as burns can disturb the components of the mitochondrial enzyme machinery as well as the related regulatory factors that play a role in cell metabolism. This disruption in cell metabolism can activate the metabolic pathology associated with burns.Conclusion: Tissue engineering is a promising approach for developing new solutions for burn repair. Cells and stem cells play a crucial role in this process. Researchers are developing new techniques to improve the delivery and viability of these cells, as well as to enhance their regenerative potential. Further research is needed to optimize these techniques and translate them into clinical practice.In addition to tissue engineering, other promising approaches to burn repair include the development of new biomaterials, such as hydrogels and scaffolds, that can promote wound healing and reduce scarring. Researchers are also exploring the use of gene therapy and other advanced technologies to accelerate tissue regeneration and improve the outcome of burn patients.