To date, skin wounds are still an issue for healthcare professionals. Although numerous approaches have been developed over the years for skin regeneration, recent advances in regenerative medicine offer very promising strategies for the fabrication of artificial skin substitutes, including 3D bioprinting, electrospinning or spraying, among others. In particular, skin sprays are an innovative technique still under clinical evaluation that show great potential for the delivery of cells and hydrogels to treat acute and chronic wounds. Skin sprays present significant advantages compared to conventional treatments for wound healing, such as the facility of application, the possibility to treat large wound areas, or the homogeneous distribution of the sprayed material. In this article, we review the latest advances in this technology, giving a detailed description of investigational and currently commercially available acellular and cellular skin spray products, used for a variety of diseases and applying different experimental materials. Moreover, as skin sprays products are subjected to different classifications, we also explain the regulatory pathways for their commercialization and include the main clinical trials for different skin diseases and their treatment conditions. Finally, we argue and suggest possible future trends for the biotechnology of skin sprays for a better use in clinical dermatology.
Keywords: ATMP, advanced therapy medicinal product; BLA, Biologic License Application; CAT, Committee for Advances Therapies; CEA, cultured epithelial autograft; CFR, Code of Federal Regulations; CHMP, Committee for Medicinal Product for Human Use; CTD, Common Technical Document; DMEM, Dulbecco's Modified Eagle's medium; ECM, extracellular matrix; EMA, European Medicines Agency; EU, European Union; FDA, Food and Drug Administration; Fibrin; GAGs, glycosaminoglycans; GLP, Good Laboratory Practice; GMP, Good Manufacturing Practice; HA, hyaluronic acid; HCT/Ps, human cells, tissues, and cellular and tissue-based products; Hydrogel; ISO, International Organization for Standardization; MA, marketing authorization; NP, Notified body; OTAT, Office of Tissues and Advanced Therapies; PCL, polycaprolactone; PEG, polyethylene glycol; PHSA, Public Health Service Act; PMA, Premarket Approval; PRF, platelet rich fibrin; PRP, platelet rich plasma; PU, polyurethane; QMS, Quality Management System; Skin; Spray; TE, tissue engineering; Tissue engineering; USA, United States of America.
© 2022 The Authors.