Current Challenges and Advances in Skin Repair and Regeneration—Second Edition

Dear Colleagues,

The skin is the human body's first barrier and acts as a defense against external stimuli, protecting against damage and injury. The structure of the skin is complex: it is composed of the epidermis, dermis, and subcutaneous fat, acting as a barrier against the penetration of damaging UV rays from the sun, the invasion of harmful pathogens, and the evaporation of water, thereby protecting the underlying organs.

In clinical practice, the interruption of skin integrity can be caused by different factors which range from iatrogenic or post-traumatic excision to severe tissue loss, such as in relation to an ulcer, tumor invasion, surgical procedures, or even alterations of the skin structure caused by chemicals or heat.

Since the skin represents the most extended and most visible organ of the human body, growing attention is given to its healing and its reconstruction. In the last few years, we have observed an increased interest in skin repair and regeneration to improve the positive results achievable with autologous grafts, either with full- or partial-thickness. Today, we observe a rising focus on dermal substitutes. They represent a valid option in the reconstruction of wounds with large amounts of dermal loss or with great scar retraction. Larger defects can be approached by the adoption of microsurgery and the harvesting of free flaps. Recently, innovative research studies have proposed the application of mesenchymal stem-cell-derived exosomes and nano-sized vesicles, which are able to induce strong anti-inflammatory, anti-aging, and wound-healing effects, thereby easing the regenerative process.

One of the most complex skin districts to reconstruct is the facial region: here, the skin has highly variable characteristics, including changes in thickness and elasticity, and contains important vascular–nervous structures.

Dr. Giovanni Salzano
Dr. Chiara Copelli
Topic Editors