Closure of the excised burn wound: temporary skin substitutes.

Prompt excision of major burn wounds has been repeatedly shown to improve survival, speed closure, and reduce infection. Immediate coverage with autograft skin is the preferred method of definitive closure of these wounds. However, when harvesting of donor skin is unavailable, or wounds are not ready for autografting, temporary closure with a variety of products can help reduce evaporative loss, prevent infection, and ameliorate pain and metabolic stress. Fresh cadaver allograft is the gold standard for such closure, but other products, including frozen cadaver skin, xenografts, and several synthetic products, are also available. This article reviews the physiology, and types of products, and their uses.