Tissue-engineered skin has been in clinical use for 25 years and has developed greatly during this time. This review looks at the role biomaterials need to play in providing for epidermal cover, dermal replacement, and epidermal/dermal replacement, and describes the major problems that remain. The majority of biomaterials in clinical use are based on natural or extracted collagen. The clinical challenges in using these materials are highlighted throughout – specifically safety issues, improving the take of cultured cells on wound beds, improving the rate of neovascularization of tissue-engineered skin, and developing scaffolds that resist contraction and fibrosis.
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