Modern techniques for wound coverage of the thermally injured upper extremity

The use of flaps; synthetic, dermal analogues; cultured skin substitutes; or a combination of these may one day help return severely burned arms to normal function and appearance. The complexity and expense of these alternatives limits their use in commonplace burns. As the techniques are refined with increased experience, so also will the roles for each of these options. Fortunately, an excellent result is still possible in most situations using simple autograft. The availability of these numerous choices to acutely cover the thermally injured upper extremity should not distract us from the gold standard of split-thickness skin graft (Fig. 7).