What is Hill Country Wound Care And Hyperbarics?

Specialized treatment for chronic, acute, and hard-to-heal wounds in San Antonio, including advanced hyperbaric oxygen therapy to accelerate healing.

What are Cellular Tissue Products (skin substitutes)?

Cellular Tissue Products (CTPs), often called skin substitutes or bioengineered tissue, are advanced biologic materials — derived from human, animal, or synthetic sources — that replace or supplement damaged skin to promote wound healing. Unlike standard dressings, CTPs provide a living or biologically active scaffold that your body's own cells can migrate into and remodel. They deliver growth factors, extracellular matrix proteins, and sometimes living cells directly to the wound bed.

How are CTPs different from a regular skin graft?

A traditional skin graft uses your own skin harvested from another part of your body — requiring a second surgical wound. CTPs eliminate that donor site by using engineered or allograft tissue. They are applied as an outpatient procedure in our clinic, require no surgery or anesthesia, and are progressively replaced by your own tissue as healing occurs.

Are skin substitutes covered by Medicare or insurance?

Yes — many CTPs are covered by Medicare and most major insurance plans for approved indications, including diabetic foot ulcers and venous leg ulcers that have failed standard care. Specific product coverage depends on wound type, size, and duration. Our billing team handles prior authorization and verifies your benefits before treatment begins, so there are no surprises.

How is a CTP applied?

The wound is first thoroughly debrided (cleaned of non-viable tissue) to create a healthy wound bed for graft acceptance. The CTP is then measured, trimmed, and applied directly to the wound bed by our physician. It is secured with a dressing and typically left in place for 5–7 days before the first follow-up assessment. Most patients require 1–4 applications depending on wound response.

Will my body reject the skin substitute?

No. Modern CTPs are processed to remove cellular components that trigger immune responses. Acellular products contain only collagen and extracellular matrix proteins — which are universally accepted by human tissue. Allograft-based products are similarly processed for biocompatibility. Rejection is not a clinical concern with these products.

How many applications will I need?

Most patients require 1–4 CTP applications, typically spaced 2–4 weeks apart, depending on wound size and healing response. Some wounds respond dramatically after a single application; deeper or larger wounds may require staged treatments. Our physicians reassess at every visit and adjust your plan based on observed tissue regeneration.

Advanced Regenerative Therapy · San Antonio

Cellular Tissue Products& Skin Substitutes

When wounds lose the biological architecture needed to heal, engineered tissue products rebuild it. Our physicians apply advanced cellular and acellular grafts that replace lost tissue, deliver growth factors, and give your body the scaffold it needs to close wounds that standard care cannot.

Living Tissue Matrix

Engineered or biologic scaffolds that actively promote regeneration

Physician-Applied

Board-certified wound physicians manage every application

Medicare Covered

Approved for diabetic & venous ulcers meeting criteria

Advanced Biologic Wound Care

What Are Cellular Tissue Products?

Cellular Tissue Products (CTPs) — commonly called skin substitutes or bioengineered tissue — are advanced biologic materials that replace or supplement damaged skin to actively promote wound closure. Unlike conventional dressings that simply cover a wound, CTPs provide a living or bioactive scaffold that your own cells can migrate into, remodel, and replace with healthy tissue.

Chronic wounds break down the extracellular matrix — the protein framework that guides cell migration and tissue growth. Without this architecture, healing halts regardless of dressing changes or debridement. CTPs restore that matrix, delivering growth factors and structural proteins directly to the wound bed to restart regeneration.

At Hill Country Wound Care, our board-certified physicians select the appropriate CTP based on wound type, size, depth, and your overall health — applying them as an outpatient procedure at any of our three Greater San Antonio locations.

CTPs are not right for every wound. Our physicians evaluate wound depth, tissue quality, drainage, infection risk, circulation, underlying conditions, and response to standard care before recommending an advanced tissue product.

Rebuilds the extracellular matrix required for cell migration

Delivers growth factors depleted in chronic wounds

No donor site required — eliminates second surgical wound

Applied in-office — no hospitalization or general anesthesia

Medicare and insurance covered for approved indications

Multiple product categories to match your wound biology

CTPs restore the biological scaffold chronic wounds destroy — giving your body the framework it needs to rebuild tissue from the inside out.

Product Categories

Types of Cellular Tissue Products

Our physicians choose from multiple product categories — matching the right biologic to your wound's specific biology, depth, and healing needs.

Acellular Dermal Matrix (ADM)

Processed human or animal dermis with cells removed, leaving a collagen scaffold. The wound bed recruits host cells into the matrix, which gradually remodels into functional tissue — ideal for deep wounds with significant tissue loss.

Bilayered Skin Substitutes

Two-layer constructs mimicking the dermis and epidermis simultaneously. The dermal layer provides structural scaffold while the epidermal layer reduces moisture loss and infection risk — used for large, complex wounds.

Amniotic Membrane Products

Derived from placental tissue, amniotic allografts deliver anti-inflammatory cytokines, growth factors, and collagen directly to the wound. Particularly effective for stalled chronic wounds and radiation injuries.

Cellular Matrix Grafts

Living constructs containing viable fibroblasts and keratinocytes that actively secrete growth factors into the wound environment. These products don't just scaffold — they biologically stimulate healing from within.

Product selection is entirely physician-driven. Our wound care physicians evaluate your wound biology, vascular status, and healing history to determine which CTP — if any — will deliver the best outcome for your specific wound.

Why CTPs Work

Benefits & Clinical Outcomes

Cellular tissue products address the biological root of chronic wound failure — not just the surface.

Closes Wounds Standard Care Can't

CTPs are specifically indicated for wounds that have failed 4+ weeks of standard care. By providing a biologic scaffold and growth factor delivery system, they bridge the biological gap that keeps chronic wounds stuck.

Provides a Healing Scaffold

Chronic wounds destroy the extracellular matrix needed for cell migration and tissue ingrowth. CTPs restore this architecture — giving your body the structural foundation to rebuild from the inside out.

Delivers Active Growth Factors

Many CTPs are bioactive, releasing PDGF, EGF, TGF-β, and VEGF directly into the wound bed — the same signals depleted in chronic wounds. This restarts the healing cascade at the cellular level.

Reduces Infection Risk

By rapidly covering the wound bed, CTPs reduce bacterial colonization and biofilm formation. Many products also carry antimicrobial properties from their source tissue, providing an additional layer of protection.

Is your wound a candidate for a skin substitute?

Our physicians evaluate wound history, vascular status, and wound bed quality to determine the right CTP for your case.

Clinical Applications

CTPs for Select Complex & Non-Healing Wounds

Cellular tissue products may be considered when a wound has not improved with appropriate standard care. Our physicians evaluate the wound type, tissue quality, drainage, infection risk, circulation, pressure, and underlying condition before deciding whether an advanced tissue product is appropriate.

Diabetic Foot Ulcers

For appropriate diabetic foot ulcers that are not progressing with standard wound care, CTPs may help support wound closure when paired with offloading, infection control, debridement when appropriate, and blood sugar management.

Venous Leg Ulcers

For select venous leg ulcers that remain open despite compression therapy and consistent wound care, CTPs may be considered to support the wound bed and help move healing forward.

Pressure Injuries

For appropriate pressure injuries that are not improving, CTPs may be considered only after pressure relief, moisture control, nutrition, infection risk, and wound-bed preparation have been addressed.

Surgical & Post-Op Wounds

For select non-healing surgical wounds, CTPs may be considered when the wound is clean, properly prepared, and not closing as expected with standard post-operative wound care.

Traumatic & Burn Wounds

For appropriate traumatic wounds or burn-related wounds, CTPs may be considered when the wound has stabilized, infection is controlled, and the wound bed is ready for advanced healing support.

Radiation-Damaged or Compromised Tissue

For select wounds affected by radiation damage or compromised tissue quality, advanced tissue products may be considered as part of a broader physician-led care plan, often alongside other therapies when medically appropriate.

Physician Evaluation Comes First

CTPs are not right for every wound. At Hill Country Wound Care & Hyperbarics, our team first identifies what is slowing healing, prepares the wound bed, and determines whether a cellular tissue product is the right next step.

Cellular Tissue Products & Skin Substitutes FAQs

Have more questions? Visit our full FAQ page or explore our articles.

Hill Country Wound Care and Hyperbarics provides Cellular Tissue Products (CTPs) and skin substitutes at our three Greater San Antonio locations: Bulverde, Live Oak, and Southwest San Antonio. Our physicians use these advanced biologics for complex diabetic and venous ulcers. To schedule an appointment, call (210) 610-8154.

Greater San Antonio

Support the Next Stage of Healing.

If your wound has failed standard care, advanced cellular tissue products may be the answer. Our physicians will evaluate your wound and recommend the right biologic therapy for your case.

(210) 610-8154