Skin Tissue Engineering: Biological Performance of Electrospun Polymer Scaffolds and Translational Challenges

Skin tissue engineering for wound healing requires a biomimetic scaffold that provides a physical, chemical, and biological environment to guide cells toward regeneration. The nanofibrous architecture provided by electrospun scaffolds, as well as the ability to tailor their surface chemistry and offer controlled delivery of bioactive agents, makes them a promising candidate for skin replacements. In this mini-review, we describe the wound healing process and the currently available engineered skin substitutes, motivating the need for a next generation of engineered skin scaffolds. We analyze how the polymeric constituents, microstructure, and biological milieu work together in electrospun scaffolds to promote a favorable behavior of skin cells. We provide a critical analysis of the optimization of physicochemical-structural properties of scaffolds and their in vivo biological performance in animal models, considering how the scaffolds perform on both a structural and biochemical level. Finally, we consider new perspectives and technological advances toward clinical implementation of electrospun scaffolds for wound healing. Lay Summary Wound healing especially in diabetic patients is problematic, and currently available treatment such as dermal substitutes present various limitations. To improve upon the currently available products, the development of polymeric nanoscaffolds on which dermal cells have been seeded proves to be more effective to regenerate and remodel tissue. This review discusses the choice of the polymers, the fabrication of mats at the nanoscale, the type of biological agents required to guide healing, and the results of in vitro and in vivo studies and how they may be further improved and scaled up toward clinical implementation.