Skin Substitutes and ‘the next level’

Modern biological and synthetic membranous wound dressings have improved treatment and outcome of partial-thickness burns. For full-thickness burns, the search for the ideal skin substitute is still ongoing. New developments are reviewed in this chapter, which comprise both materials and cell-seeded constructs. Cultured epidermal cells were used in burn treatment for decades, with moderate success. However, new culture and application techniques have revived the interest in this technology. Dermal substitutes have gained a position in modern burn care, and new developments combine the use of epidermal cells and dermal equivalents including dermal cells, generating full skin substitutes. Next to technological advances the regulatory position of advanced therapy medicinal products is highlighted because they have become important parts of the development of cell-seeded skin substitute products.