Tissue-engineered skin substitutes (TESSs) are at the leading edge of innovation in wound healing. These treatments address underlying problems of wound healing by targeting cellular and molecular mechanisms. The global TESS market was valued at $1.3bn in 2017 and is expected to reach $2.3bn by 2024, with a robust compound annual growth rate (CAGR) of 8.0%.

Biologic skin substitutes represent the largest segment in the space, compared with synthetic and biosynthetic skin substitutes. According to GlobalData, more TESSs based on amniotic technologies will be used in clinical practice in the next five years.

There are cellular and acellular products based on amniotic technologies. Cellular products, such as Grafix from Osiris Therapeutics, provide the benefits of fresh placental membrane, and reduce inflammation and scarring by supporting wound closure without excessive fibrosis.

More acellular products are available in the market, including NEOX/CLARIX from Amniox Medical, EpiFix from MiMedx Group, and Biovance from Alliqua Biomedical. These acellular products don’t contain active or living cells, but may contain and stimulate growth factors, cytokines, and matrix proteins, providing mechanical substrate for tissue growth. Compared with cellular products, they have fewer regulatory and scientific challenges.