[Current treatment burn wounds: alternative wound coverage methods]

In patients with massive burn injuries and very limited skin donor sites, both acute-phase and long-term problems of skin loss must be solved by the use of alternative wound closure materials. Alternative materials can be used for either temporary wound coverage or for permanent wound closure. Recently, allogenic skin grafts have most commonly been used as alternative wound closure material. However, research is ongoing on many new materials to provide a readily available substitute for skin allografts for permanent wound closure. The best approach to the development of alternative permanent wound closure materials is to incorporate the host's own cellular and structural components. Four general strategies have been devised so far based on the type of matrix structure and cellular content: allografts; cultured epidermal grafts; dermal matrix grafts; and cultured-dermal matrix composite grafts. Several approaches using combined alternative wound closure materials have been used, including transplantation of artificial dermal matrix with thin epidermal autografts, and transplantation of artificial dermal matrix containing human fibroblasts. Ultimately, the best candidate materials for permanent wound closure after extensive burn injury must be determined in prospective, randomized, controlled clinical trials.