Delivery systems of current biologicals for the treatment of chronic cutaneous wounds and severe burns

To promote wound repair, strategies consisting of the administration of purified biologicals such as cytokines, growth factors and DNA/RNA; the delivery of biologicals from living systems, such as cells (cultured keratinocytes, stem cells), skin grafts or skin equivalents; or the combined delivery of purified biologicals and biologicals from living systems have been used. Purified biologicals can be applied systemically or locally by topical application or injections, which result in an uncontrolled burst release; they can also be encapsulated into predesigned biomaterial-based delivery systems such as scaffolds or hydrogels that better mimic the native ECM, then delivered to the wound area, which results in a gradient spatial release. In the future, use of biomimetic scaffolds/hydrogels incorporated with critical stem cell populations and growth factors or DNA/RNA released in a programmed spatiotemporal manner, taking into account genetic variability, wound type, and the patient's clinical and metabolic features, will offer more personalised and thus more effective therapies. Perhaps this will ultimately allow us to achieve foetal wound healing properties in adult wound healing, with complete regeneration of hair follicles and sweat glands, without chronicity or scarring.192