Advancements in surgical wound treatment have led to skin substitutes and bioscaffolds as temporary and permanent coverage for burn wounds. Skin substitutes are used to improve wound coverage and restore the functional and aesthetic qualities of skin, and help to prevent wound infection and maintain a moist wound healing environment. Although allografts are preferred when autografts are not possible, high costs and limited availability have led to the use of xenografts and the development of skin substitutes and bioscaffolds. Despite constant evolution in the development of these skin substitutes and bioscaffolds, no single product stands out as the gold standard.
Key points
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The goals of skin substitutes are prevention of wound infection, maintenance of moist wound healing environment, and replacement of normal skin to restore function and aesthetics.
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Allografts have always been the temporary coverage of choice when donor autografts are limited, but factors such as availability and cost are of concern.
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Xenografts can provide temporary coverage, but because of their inability to revascularize fully they should be viewed more as a dressing than as a skin substitute.
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Despite constant evolution in the development of skin substitutes, no single product stands out as the gold standard.
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When choosing a skin substitute, several practical issues, including wound indication, ease of application, storage time, and cost, factor into the choices made by clinicians.
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