Review paper: Burn coverage technologies: Current concepts and future directions

Advances in skin replacement technologies have focused on artificial skin constructs such as amnion and cadaveric skin and xenografts. One classification of skin substitute is epidermal reconstruction, which include the growth of keratinocytes. Cell therapy is an emerging therapeutic strategy aimed at replacing or repairing severely damaged tissues with cultured cells. There have been developments recently on blends of polyether amide with polybenzimidazole which could provide a tissue compatible scaffold with lowered adhesive properties. This might be useful for the transfer of cells by passing enzymatic detachment. Another is a biodegradable keratinocyte delivery system called Laserskin for use in keratinocyte grafting. Dermal reconstruction solutions have been classified based upon the absence or presence of cellular components, to acellular and cellular dermal construct. Accelular dermal constructs like Integra exhibits a bilaminar structure, consisting of cross-linked bovine collagen and glycosaminoglycan, coated on one side with a silicone membrane that provides epidermal function. On the one hand, cultured dermal constructs enhances more the re-epithelialization of a full thickness skin defect when compared to an acellular dermal substitute scaffold. Culturing fibroblasts on a specially designed scaffold are key to the preparation of alogeneic cultured dermal substitutes. On the one hand, bilayered skin construct consisting of human neonatal keratinocytes and fibroblasts in a collagen matrix and laboratory-grown bilayered living skin substitute have been successful in treating a variety of wounds.