Apligraf, a manufactured living human skin equivalent, was the first true composite tissue analog to become commercially available. It has been approved by the FDA for the treatment of venous leg ulcers and diabetic foot ulcers. The tissue engineered bi-layered skin equivalent has both an epidermis and a dermis, which consist of keratinocytes and fibroblasts derived from neonatal foreskin and bovine collagen. The skin equivalent produces a great number of cytokines and growth factors and is immunologically well tolerated. The product is easy to handle in clinical use and can be applied in an outpatient setting.
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