Skin and oral mucosa equivalents: construction and performance

The skin and the oral mucosa act as a barrier against the external environment. Loss of this barrier function causes dehydration and a high risk of infection. For the treatment of extensive skin wounds such as in severe burns, autologous skin for transplantation is often not available in sufficient amounts. Reconstructions in the oral cavity, as required after tumor resections or cleft palate repair, are often complicated by similar problems. In the last two decades, the field of tissue engineering has provided new solutions to these problems. Techniques have been developed for the culture of epithelial grafts, dermal substitutes, and the combination of these two to a 'functional' skin or mucosa equivalent. The present review focuses on developments in the field of tissue engineering of skin and oral mucosa. The performance of different types of engineered grafts in animal models and clinical studies is discussed. Recent developments such as the use of epithelial stem cells, and gene therapy with transduced skin grafts are also discussed.