Skin substitutes are a growing market since technical advancements have allowed a substantial progress in treating extensive defects of the skin. A variety of
skin substitutes with different properties and thus resulting different indications is offered on the market. Important benefits of
skin substitutes are their ready availability in almost any quantity and the predictable product properties concerning implantation, incorporation, resorption and long-term outcome. Although, most
skin substitutes still need skin grafts at a later date which is disadvantageous. Nevertheless dermal substitutes have reduced the need for thick skin grafts allowing the donor site and the patient to heal faster with fewer surgeries. The use of
skin substitutes in
dermatologic surgery is widespread and new fields of application are emerging. The variety of
artificial skin has definitely changed the reconstructive ladder helping to cover larger defects with less time and effort which is an important issue especially in elderly and multimorbid patients. In the last years a growing number of studies in the literature report the use of
artificial skin substitutes to secure a rapid reconstruction with reliable cosmetic and functional results after oncological resections. Furthermore,
skin substitutes are used to cover chronic
wounds like
diabetic foot ulcers or venous
leg ulcers to promote healing. Congenital diseases like giant hairy
nevi, aplasia cutis congenital or
epidermolysis bullosa are conditions in children where
skin substitutes play a role. But even in tissue augmentation or in cosmetic surgery
skin substitutes come into vogue. The latest advance are cultured autologous or allogenic substitutes some even in combination with alloplastic material. Besides of medical questions that arise from the use of these materials in reconstructive surgery legal and economic aspects have to be taken into account. This article is giving an overview over the most common
skin substitutes and their use in dermatosurgery.