ARTIFICIAL SKIN AND ARTIFICIAL CARTILAGE

PRESENTED BY
PWADUBASAHIYI COSTON PWAVODI 20143883 MSC.
FELIX CHIBUZO OBI 20144610 MSC.
MICHAEL OLABOYE AMUSAN 20103181
ARTIFICIAL ORGANS
DEPARTMENT OF BIOMEDICAL
ENGINEERING..

INTRODUCTION
• The term artificial skin is used to describe any material used
to replace (permanently or temporarily) or to mimic the
dermal and epidermal layers of the skin.
• The primary current application of artificial skin is for the
treatment of skin loss or damage on burn patients.
• Alternatively however, artificial skin is now being used in
some places to treat patients with skin diseases, such as
diabetic foot ulcers, and severe .[1]

ANATOMICAL OVERVIEW OF THE SKIN
• Human skin is
comprised of two
primary layers, the
dermis and the
epidermis. A diagram
of a typical section of
human skin is shown
here. The epidermis is
comprised of
keratinocytes of
varying levels of
differentiation.
• As can be seen in the
figure, the epidermis
contains no blood
vessels meaning
transport of nutrients to
the epidermis occurs
from the dermis below
[2].

BRIEF HISTORY OF THE ARTIFICIAL SKIN
• 3000-2500BC, India: Skin is allegedly transplanted by
Hindus from the buttocks to repair mutilated ears and noses.
• 1442, Italy: An allogenous skin graft was performed by
Branca de Branca who used a man’s arm skin to transplant
the nose of the man’s slave onto himself.
• 1871, England: Pollock proposes skin grafts for burn
treatment.
• 1998, United States: First tissue engineered skin (Apligraf)
is approved by the FDA.
• 2001, United States: Dermagraft, Orcel, Composite Cultured
Skin are FDA approved [4].
• 2002, United States: Integra is FDA approved for treatment
of severe burns [4].

PROCESSES INVOLVED IN THE
MANUFACTURE OF THE ARTIFICIAL SKIN
Skin is usually donated by other donors.
• Fibroblasts are removed from the donated skin and
are frozen until they are needed.
• The fibroblasts are placed on a polymeric mesh
scaffolding, gather oxygen, and grow new cells.
• The cells are then transferred to a culture
system.After 4 weeks the polymer mesh dissolves and
leaves behind a new layer of dermal skin.
• When the growth cycle is completed, they add more
nutrients. Keratinocytes are added to the collagen and are
exposed to air to form epidermal layers.
• The skin is now completed and is stored in
sterile contains until ready to use.

Skin Grafts
• Skin grafts are required for patients with skin damage that is
too significant for self-repair. As stated before, one of the
primary requirements for artificial skin is for the treatment
of severe burn victims. [2
• Skin grafts are also often done on patients with ulcers, skin
loss from cancer removal, and plastic surgery [1]
• The skin required for a skin graft can be obtained from three
sources; the patient themselves (autograft), another human
(allograft), or from animals such as pigs or cows
(xenografts)[2]. Allografts and xenografts can only be used
as temporary wound coverings as they are typically rejected
within 7 to 10 days or 3 to 5 days respectively [2].

Artificial Skin Treatments
• Since 2001, a total of 4 skin repair devices have been FDA
approved. These include Dermagraf, Orcel, Integra, and
Composite Cultured Skin [4]. Composite Cultured Skin is
specifically for children with recessive dystrophic
epidermolysis bullosa and also contain living cells.

AREAS OF APPLICATION
Artificial Skins are primarily used for the Treatment of Skin
loss or damage on burn Patients. Alternative Areas of
Application of Artificial Skins includes
• -Treatment of patients with skin diseases, such as diabetic
foot ulcers, and severe scarring.
• - Plastics and Cosmetic Surgery.

ADVANTAGES AND DISADVANTAGES
ADVANTAGES
• -Chances of survival for burn patients.
• -Artificial skin seals the wound preventing fluid loss and bacteria
from entering through the wound.
• - The fear of Stigmatization of the Patient is eliminated
DISADVANTAGES
• -Risks of Infection and Rejection by the Patients
• -Lack of vascularization to the implanted skin or skin cells
can lead to cell death which provides a breeding ground for
bacteria.
• -Loss of Sensitivity
• -Cut of Blood Supply.
• -Complication could arise due to Skin Adhesion and/or fluid
buildup between the wounded site and the transplanted skin.
• - Artificial Skins are very expensive.

RECENT DEVELOPMENTS OF THE ARTIFICIAL SKIN/ONGOING
RESEARCH
• Though artificial skin has aided significantly in skin
regeneration, there remain several areas for improvement.
Ongoing Research attempt to produce bacteria-resistant skin
cell cultures that can be used in artificial skin. Ideally, this
would allow in vitro replication of a patient’s own
genetically modified skin cells. These cells could then be put
into the artificial matrix for bacteria-free growth.
• Another current trend in Artificial is the creation of
Electronic Skin. Scientist are working towards the
Incorporation of flexible pressure transducers and
Bioreceptors to the Artificial Skin, these will give a sense of
Touch to the Patients.
• Outside of artificial biological skin, synthetic skin is being
developed in hopes of enabling the sensation of touch to
non-living structures. Flexible pressure transducers may
eventually allow us to create an electronic “skin” with
signals to mimic the sense of touch. This has applications in
robotics including advanced prosthetic limbs [8].

RECENT DEVELOPMENTS OF THE ARTIFICIAL SKIN/ONGOING
RESEARCH
• Other advances have been made in the application of cells to
the matrices. Dr. Fiona Woods has produced a “spray on
skin” called Cellspray. This method takes healthy cells from
the patient and creates a suspension culture of the cells. The
cells are then distributed by spraying them evenly across the
matrix. It is believed that this method will be beneficial
because the suspension cell culture can be produced much
faster (5 days) than traditional methods which require
formation of a sheet of cells (21 days). Though this
procedure has not been through clinical trials, it was
controversially used on burn victims in conjunction with
traditional methods in the Bali bombings in 2004. Further
testing is required before this treatment can officially be
deemed successful.

CONCLUSION
• The ultimate goals of current artificial skin
technologies are to provide protection from
infection, dehydration, and protein loss after
severe skin loss or damage.

REFERENCES
• [1] Dantzer, E., Queruel, P., Salinier, L., Palmier,
B., & Quinot, J. F. (2001). Integra, a new surgical
alternative for the treatment of massive burns.
Clinical evaluation of acute and reconstructive
surgery: 39 case. Annales De Chirurgie Plastique
Esthétique, 46(3), 173-189.
http://www.ncbi.nlm.nih.gov/pubmed/11447623
• [2] Roos, D. (2012). Skin grafts. Retrieved 02/29,
2012, from http://health.howstuffworks.com/skin-
care/information/anatomy/skin-graft.htm
• [3] Heman, A. R. (2002). The history of skin
grafts. Retrieved 02/29, 2012, from
http://findarticles.com/p/articles/mi_m0PDG/is_3_
1/ai_110220336/

INTRODUCTION
• Articular cartilage is a highly organized avascular tissue
composed of chondrocytes embedded within an extracellular
matrix of collagens, proteoglycans and noncollagenous
proteins. Its primary function is to enable the smooth
articulation of joint surfaces, and to cushion compressive,
tensile and shearing forces. Hyaline cartilage has one of the
lowest coefficients of friction known for any surface to
surface contact.
• Cartilage is unique as it is an avascular, aneural tissue, in
which cells survive for a lifetime, without intercellular
connections.Owing to its sophisticated composition, its high
water content and its ability to withstand hydrostatic
pressurization, cartilage is capable of transferring enormous
forces relatively evenly from one subchondral bone plate to
the other.

OVERVIEW OF THE ANATOMY OF THE
CARTILAGE
• Cartilage is a flexible connective tissue found in many
areas in the bodies of humans and other animals, including
the joints between bones, the rib cage, the ear, the nose,
the bronchial tubes and the intervertebral discs. It is not as
hard and rigid as bone but is stiffer and less flexible than
muscle.
• ARTICULAR CARTILAGE?
Hyaline articular cartilage is a complex structure, developed
and progressively refined over hundreds of millions of
years. Articular cartilage provides smooth articulation
under variable loads and impaction for very long periods
of time. It serves as the load-bearing material of joints,
which has excellent friction, lubrication and wear
characteristics. The cartilage thickness varies significantly
across articular surfaces of the same joint. Normal hyaline
cartilage has a glossy, bluish white, homogenous
appearance, firm consistency and some elasticity. .

• Cells called chondrocytes
• Abundant extracellular
matrix
– Fibers: collagen & elastin
– Jellylike ground substance
of complex sugar molecules
– 60-80% water (responsible
for the resilience)
– No nerves or vessels

BRIEF HISTORY OF THE ARTIFICIAL
CARTILAGE
• The history up to 1900 is told chronologically, divided
into (1) recognition of the tissue, (2) structure, and (3)
chemistry. The twentieth century is sketched with a
timeline of discoveries that at the time were important and
a bibliography of journal review articles.
• By 1900 the avascular, aneural state and fibrillar
composition have been accepted. The nutrition of articular
cartilage remained in dispute. The composition of the
binding substance and its relation to collagen remained
unknown. Research in the first half of the twentieth
century continued to be impeded by lack of technology.
The advent of electron microscopy, isotopic tracer
technics and enzymology rapidly accelerated the
understanding of hyaline cartilage beginning in the 1950s.

MANUFACTURING PROCESSES
Unique building block of articular cartilage matrix is Type II
collagen
• Middle architectural zone called “the netting” is made of
aggregates of proteoglycans called glycosamino- glycans
(GAG’s): This netting holds water i.e.: gives this zone its
hydrophilic character that yields the low friction, fluid wave
enabling smooth joint motion

• Restore smooth articular cartilage surface
• Relieve patient symptoms and improve function
• Match biomechanical/biochemical properties of normal hyaline
cartilage
• Prevent or slow progression of focal chondral injury to end-
stage arthritis
• Scaffolds to enhance Micr0-fx marrow cell stimulation
• 2nd Generation Cell Techniques
• Minced Cartilage ( One stage techniques)
• 3rd Generation cell techniques
• Concurrent Use of Growth factors/ BMP’s
• Enhanced Stem cell derived:

Scaffolds
• Region-specific
• Conductive : several
substrates
Including chitosan/ fibrinogen
• Bio-replaced
• Cost-effective
– May act as Micro-fx adjunct
ie: Scaffold guided
regeneration

2nd Generation Cell Therapies
• Autogenous cells
• Seeded scaffold or liquid
gel
• Minimizes periosteal
related complications
• Allows arthroscopic
implant

3rd Generation Cell Based
• Autogenous
• Allogeneic
• 3-D Cartilage graft
• Technical ease might allow
arthroscopic insertion with
bioadhesive

Other 3rd Generation Potential Enhancements:
– Expanded Juvenile chondrocytes
– Scaffold independent cx
• Clinical: Phase I completed:
– FDA Phase II/III IND/BLA pending
Sheep Allograft 8 Weeks
Juvenile Cartilage Adult Cartilage

CURRENT TRENDS/RESENT DEVELOPMENT
OF THE ARTIFICIAL CARTILAGE
• A resent development of the Artificial Cartilage is it use in the
treatment of knee Injury. Studies have shown that almost half of
all running injuries are knee injuries, tears could sometimes occur.
For instance, Meniscus (the cartilage pad between the thigh and
shin bones) tears can occur when a runner takes a misstep or
twists, pivots or compresses the knee joint in the wrong way.
• Biomedical Engineers are now able to implant Artificial Cartilage
into patient’s knee that could restore much of the function to the
damaged meniscus.
• Another recent Application of the Artificial Cartilage is in
Allograft Osteochongraph Transplantation (AOT). This is the
process whereby the Cartilage is obtained from a recently
deceased donor. It is then tested in the Laboratory to make sure it
is free from Infection before been transplanted to the Patient.
•

ONGOING RESEARCH IN THE
ARTIFICIAL CARTILAGES
• A number of ongoing research projects are currently
investigating more efficient and effective ways of
repairing cartilage.
• Examples of current research projects include:
• investigating ways of using different sources of stem
cells to generate new cartilage (for example, bone
marrow or fat)
• using donor stem cells to regenerate cartilage
• combining cartilage and stem cells to improve repair
• Although these projects are still in the early stages,
researchers are optimistic they will lead to new kinds
of treatment.

AREAS OF APPLICATIONS OF THE
ARTIFICIAL CARTILAGE
• The Treatment of knee Injury
• Articular Cartilage: the smooth, white tissue
that covers the ends of bones where they come
together to form joints
• Nose, Ear etc

ADVANTAGES OF THE ARTIFICIAL
CARTILAGE.
• It can protect runners from arthritis and total knee replacement
• It can be use to correct birth defects
• It brings hope and confidence to Patients
•
• DISADVANTAGES OF THE ARTIFICIAL CARTILAGE
• The Risk of complication and Infection
• It could be rejected the patient’s body
• It’s expensive

ARTIFICIAL SKIN AND ARTIFICIAL CARTILAGE

ARTIFICIAL SKIN AND ARTIFICIAL CARTILAGE

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