What a skin substitute for wounds is

A skin substitute for wounds is a manufactured or processed material that a clinician places over a wound to support the body’s own healing. Despite the name, it does not replace your skin the way a transplant would. Most act as a temporary cover and a framework that your own cells can grow into.

You may hear other names for the same group of products, including cellular and tissue-based products and bioengineered skin. They usually come as thin sheets, and they are not all alike.

What skin substitutes are made from

The source material matters to many people, so ask about it. The broad groups are:

  • Donated human tissue. This includes processed donor skin and tissue from the placenta, donated after a birth. Donors are screened, and the tissue is tested and processed.
  • Animal tissue. Collagen-rich tissue from pigs, cattle, fish or other animals is cleaned and processed to leave a framework.
  • Synthetic materials. Man-made materials are designed to act as a scaffold.
  • Combinations. Some products pair a framework with living human cells grown in a laboratory.

How a skin substitute differs from a skin graft

A skin graft uses your own skin. A surgeon takes a thin layer from one part of your body and attaches it over the wound, usually in an operating room. You then have two areas to look after, which is what skin graft and donor site follow-up is for.

A skin substitute comes from a package, not from your body. It can often be applied during a regular visit, and there is no donor site. The two are used in different situations, and the clinician or surgeon decides which applies, if either.

When clinicians consider a skin substitute

These products are not a first step. They are most often discussed for chronic wounds, such as diabetic foot ulcers and venous leg ulcers, that have not made enough progress after a period of good standard care.

A clinician generally wants the basics in place first:

  • The cause of the wound identified and addressed
  • Enough blood flow to the area
  • No active infection
  • Dead tissue removed
  • Pressure kept off a foot wound through offloading, or compression therapy in use on a venous leg wound
  • Blood sugar, nutrition and smoking addressed with primary care, including diabetes care

A skin substitute works on top of this care, not in place of it.

What application and follow-up involve

The treating clinician prepares the wound, places the product and covers it with a dressing. You will get instructions about keeping the dressing in place and dry, and about pressure and activity. Follow them closely, because the product needs to stay in contact with the wound.

At later visits, the clinician measures the wound and decides whether to apply the product again or change course. What you see may surprise you. Some products dissolve, some turn into a gel and some become part of the wound bed. Ask what is normal for yours.

Gateway arranges assessments with partner clinicians in Greater St. Louis and the Metro East, as our page on skin substitutes for wounds explains. The treating clinician chooses the product. Gateway does not recommend products to patients.

Questions to ask about a skin substitute

  • Why do you think my wound is ready for one, and what are my other options?
  • What is this product made from?
  • How many applications do you expect, and how will you judge whether it is working?
  • Has my plan been checked, and what might I owe?

Coverage rules for these products are detailed and vary by plan. The treating provider’s office reviews benefits and any prior authorization before treatment. Ask for the answer before the first application, and confirm it with your plan.

What to report after an application

Call the treating clinician’s office if:

  • The dressing slips, comes off, gets wet or soaks through
  • Drainage increases, turns thick or cloudy, or develops an odor
  • Redness, warmth, swelling or pain spreads or increases
  • You have fever or chills
  • A rash or itching appears around the area

Do not remove or replace the dressing unless you were told to. Call 911 for trouble breathing, swelling of the face or throat, fainting, sudden confusion or heavy bleeding.

To ask about arranging an assessment, call 314-325-0126 or use the request care form, which collects contact details only.

Common questions

Will a skin substitute turn into my own skin?

Not exactly. Most skin substitutes give your cells a surface and a structure to grow on. Over time the material is usually absorbed, replaced by your own tissue or lifted away as the wound closes. The skin that finally covers the wound is yours.

Can my body reject a skin substitute?

These products are processed to lower the chance of a reaction, and the anti-rejection medicines used after an organ transplant are generally not part of this kind of care. Reactions can still happen. Tell the clinician about your allergies, including any to animal products or antibiotics. Afterward, report rash, itching, swelling, increased pain or signs of infection promptly.

I avoid pork or beef products. Can I still have a skin substitute?

Tell the clinician before any product is chosen. Skin substitutes come from several sources, including human donor tissue, different animals and synthetic materials, so there may be an option that fits your beliefs or preferences. If no suitable option exists, the clinician can discuss continuing other care.

Do I still need compression or offloading once a skin substitute is on?

Almost always, yes. The problem that caused the wound, such as swelling in the leg or pressure on the foot, is still there. A skin substitute placed on a wound that is still swollen or still being walked on is unlikely to succeed. Follow the clinician’s instructions for wraps, footwear, devices and activity, and ask whether any of them change after an application.

Related pages

General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.

Updated October 2026