Last updated: 11/24/2009

There has been great progress in the development of artificial skin replacement products in recent years. Although nothing works as well as the patient's own skin, artificial skin products are important due to the limitation of available skin for allografting...

in severely burned patients. Unlike allographs and xenographs, artificial skin replacements are not rejected by the patient's body and actually encourage the generation of new tissue. Artificial skin usually consists of a synthetic epidermis and a collagen-based dermis. The artificial dermis consists of fibers arranged in a lattice that act as a template for the formation of new tissue. Fibroblasts, blood vessels, nerve fibers, and lymph vessels from surrounding healthy tissue grow into the collagen lattice, which eventually dissolves as these cells and structures build a new dermis. The synthetic epidermis, which acts as a temporary barrier during this process, is eventually replaced with a split-thickness autograft or with an epidermis cultured in the laboratory from the patient's own epithelial cells.

Several artificial skin products are available for burns or non-healing wounds, including Integra®, Dermal Regeneration Template® (from Integra Life Sciences Technology), Apligraft® (Novartis), Transcyte® (Advance Tissue Science), and Dermagraft®. Researchers have also obtained promising results growing or cultivating the patient's own skin cells in the laboratory. These cultured skin substitutes reduce the need for autografts and can reduce the complications of burn injuries. Laboratory cultivation of skin cells may improve the prognosis for severely burned patients with third-degree burns over 50% of their body. The recovery of these patients has been hindered by the limited availability of uninjured skin from their own bodies for grafting. Skin substitutes may also reduce treatment costs and the length of hospital stays. In addition, other research has demonstrated the possibility of using stem cells collected from bone marrow or blood for use in growing skin grafts.

Patients with less severe burns are usually treated in a doctor's office or a hospital emergency room. Patients with any of the following conditions, however, are usually transferred to hospitals with specialized burn units: third-degree burns; partial-thickness burns over 10% of their total body area; electrical or chemical burns; smoke inhalation injuries; or preexisting medical disorders that could complicate management, prolong recovery, or affect mortality. In addition, burned children in hospitals without qualified personnel should be admitted to a hospital with a burn unit. A surgical team that specializes in burn treatment and skin grafts will perform the necessary procedures. The team may include neurosurgeons, ophthalmologists, oral surgeons, thoracic surgeons, psychiatrists, and trauma specialists as well as plastic surgeons and dermatologists.