Skin substitutes in chronic wounds

There is a large demand for skin substitutes for the coverage of chronic wounds. Due to a intensive and local wound treatment the impaired dermal and epidermal repair still remains a major problem. Known treatmentes as split-skin-, reverdin- and pinch grafts make a sufficient and solid wound closure possible. However in such procedures the take rate of grafting often failes. The graft healing is increased with combined mesh-graft and vacuum-seating technique. Temporary and permanent skin substitutes extend the spectrum in closure of chronic defects. Sheets and single cell suspensions of keratinocytes are available for clincial treatments. First clinical results with autologous keratinocyte transplantation are described. In the future approaches in gen therapy becomes more and more important for skin substitutes.