Skin Substitutes in Burn Management. A Practical Review
Main Article Content
Abstract
This review examines the diverse landscape of skin substitutes used in burn management, highlighting their classification based on composition—biological, synthetic, and bioengineered—and structural function—epidermal, dermal, and composite. Skin substitutes serve critical roles in restoring skin integrity, preventing infection, and promoting healing, especially when autologous grafts are limited. Recent advances, such as off-the-shelf decellularized matrices and 3D bioprinting, show promise for personalized and efficient skin regeneration. The review emphasizes that successful wound healing depends not only on the choice of skin substitute but also on complementary dressing strategies that maintain optimal moisture, prevent infection, and support graft integration. A tailored combination of suitable dressings (e.g., hydrocolloids, alginates, foams, hydrogels) enhances healing outcomes. Overall, an integrated approach leveraging advanced materials and dressing techniques is vital for optimal burn wound management and patient recovery.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Kondej K, Zawrzykraj M, Czerwiec K, et al. Bioengineering Skin Substitutes for Wound Management-Perspectives and Challenges. International Journal of Molecular Sciences. 2024;25(7):3702. doi:10.3390/ijms25073702.
II. Greenhalgh DG. Management of Burns. The New England Journal of Medicine. 2019;380(24):2349-2359. doi:10.1056/NEJMra1807442.
III. Goodarzi P, Falahzadeh K, Nematizadeh M, et al. Tissue Engineered Skin Substitutes. Advances in Experimental Medicine and Biology. 2018;1107:143-188. doi:10.1007/5584_2018_226.
IV. Chogan F, Chen Y, Wood F, Jeschke MG. Skin Tissue Engineering Advances in Burns: A Brief Introduction to the Past, the Present, and the Future Potential. Journal of Burn Care & Research. 2023;44(Suppl_1):S1-S4. doi:10.1093/jbcr/irac127.
V. Boyce ST, Kagan RJ. Composition and Performance of Autologous Engineered Skin Substitutes for Repair or Regeneration of Excised, Full-Thickness Burns. Journal of Burn Care & Research. 2023;44(Suppl_1):S50-S56. doi:10.1093/jbcr/irac107.
VI. Nyame TT, Chiang HA, Leavitt T, Ozambela M, Orgill DP. Tissue-Engineered Skin Substitutes. Plastic and Reconstructive Surgery.
;136(6):1379-1388. doi:10.1097/PRS.0000000000001748.
VII. Łabuś W, Kitala D, Szapski M, et al. Tissue Engineering in Skin Substitute. Advances in Experimental Medicine and Biology. 2021;1345:193-208. doi:10.1007/978-3-030-82735-9_16.
VIII. Magne B, Demers A, Savard É, et al. Speeding Up the Production of Clinical-Grade Skin Substitutes Using Off-the-Shelf Decellularized Self-Assembled Dermal Matrices. Acta Biomaterialia. 2023;167:249-259. doi:10.1016/j.actbio.2023.05.053.
IX. Lee A, McKean AR, Wormald JCR, et al. A Clinician Survey of Skin Substitute Use in Burns Care in the UK and Ireland: The CASSIUS Study. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2025;102:238-246.
doi:10.1016/j.bjps.2025.01.064.
X. Singer AJ, Tassiopoulos A, Kirsner RS. Evaluation and Management of Lower-Extremity Ulcers. The New England Journal of Medicine. 2017;377(16):1559-1567. doi:10.1056/NEJMra1615243.
XI. Gallagher KA, Mills JL, Armstrong DG, et al. Current Status and Principles for the Treatment and Prevention of Diabetic Foot Ulcers in the Cardiovascular Patient Population: A Scientific Statement From the American Heart Association. Circulation. 2024;149(4):e232-e253. doi:10.1161/CIR.0000000000001192.
XII. Skórkowska-Telichowska K, Czemplik M, Kulma A, Szopa J. The Local Treatment and Available Dressings Designed for Chronic Wounds. Journal of the American Academy of Dermatology. 2013;68(4):e117-e126. doi:10.1016/j.jaad.2011.06.028.
XIII. Hingorani A, LaMuraglia GM, Henke P, et al. The Management of Diabetic Foot: A Clinical Practice Guideline by the Society for Vascular Surgery in Collaboration With the American Podiatric Medical Association and the Society for Vascular Medicine. Journal of Vascular Surgery. 2016;63(2 Suppl):3S-21S. doi:10.1016/j.jvs.2015.10.003.
XIV. Monsuur, H. N., Weijers, E. M., Gibbs, S., & van den Broek, L. J. (2019). Skin substitutes are more potent than dermal or epidermal substitutes in stimulating endothelial cell sprouting. BMC Biomedical Engineering, 1, 1-7.