**13. ASCs and skin tissue engineering**

Böttcher-Haberzeth and colleagues have extensively reported the development of a skin substitute known as tissue-engineered dermo-epidermal skin substitutes (DESS). It is made of the two basic native skin layers, epidermal and dermal layers, and it can potentially serve as a near replacement for the natural skin for clinical application [75]. Adipose-derived stem cells are attractive and valuable tools for regenerative skin engineering as they can differentiate into different skin cell lineages as well as secrete paracrine factors responsible for initiating skin tissue repair and regeneration.

Trottier and colleagues demonstrated the endogenous production of the extracellular cell matrix components by various skin cells known as IFATS collection. The authors reported that through this method there was formation of strong multiple layers of cell sheet that lead to increase in the skin graft thickness. The authors recorded satisfactory epidermal thickness and stratification [76]. In another study by [77], the authors seeded ASCs onto different scaffolds to determine the differentiation fate of the respective cells. The ASCs seeded on collagen type 1-based matrix and PEGylated fibrin-based scaffold differentiated into fibroblast-like dermal cells and blood capillary network, respectively. Recently, tropoelastin-based scaffold for skin substitutes was developed by [78]. Briefly, biomimetic scaffold was seeded in vitro with ASCs and transplanted onto the SCID mice. The authors concluded that ASCs grew rapidly and colonized the scaffold that resulted in increased epidermal thickness in vivo.
