**6. Adjuncts to wound healing**

#### **6.1 Bioengineered skin**

One of the best examples of Bioengineered skin is the *Apligraf:* a bi-layered bioengineered skin substitute composed of 'bovine type I collagen matrix populated with human male neonatal fibroblasts and an epidermal sheet derived from male neonatal epidermal keratinocytes', that has been approved by the US Food and Drug Administration (FDA) for cases where standard wound care has failed to treat ulcers. The mechanism that initiates wound healing by the use of these bioengineered products is still being researched but it has been revealed that these cells grow and proliferate, and produce growth factors, collagens, and extracellular matrix proteins, all of which are known to positively stimulate re-epithelialisation, formation of granulation tissue, angiogenesis, and neutrophil and monocyte chemotaxis. Thus, these have the potential to provide a potent cellular remedy and adaptable response in acute and chronic wounds [63].
