51.8 Types of Skin Substitutes and grafts

Autograft: Source and coverage

Patient’s own unburned skin

May be meshed to cover larger areas or placed as a sheet on faces and hands for a smoother, more cosmetic appearance

Permanent

Autograft: Benefits and drawbacks

This is the ideal coverage for all patients’ burns and has the highest chance of wound closure.

May be delicate if meshed widely before application. Staple removal may be tedious.

Cultured epithelial autograft (CEA): Source and coverage

Patient’s own skin sample is sent to a laboratory, where the epidermis is grown in larger patches.

Permanent

Cultured epithelial autograft (CEA): Benefits and drawbacks

Is a good choice in patients with large burns of 70% or more TBSA burn who do not have enough unburned skin to use as donor for autografting

Is extremely expensive, very fragile, and susceptible to infection once applied. Dermal layer will never regenerate.

Integra(Artificial skin): Source and coverage

Two-layer man-made silicone membrane used to replace dermis and is covered with autograft

Permanent

Integra(Artificial skin): Benefits and drawbacks

May provide a functional dermis and better chance of wound closure

High risk for infection of the Integra and subsequent graft loss

Allograft: Source and coverage

Cadaver skin

Temporary

Allograft: benefits and drawbacks

Used as a temporary covering once eschar is removed to help close and protect wound

Will eventually reject and have to be replaced by permanent grafting

Xenograft: Source and coverage

Pig (most common) or bovine (cow) skin

Temporary

Xenograft: Benefits and drawbacks

Used as a temporary covering once eschar is removed to help close and protect wound

Will eventually reject and have to be replaced by permanent grafting