Closure of the excised burn wound: autografts, semipermanent skin substitutes, and permanent skin substitutes.

Although definitive closure of the excised burn wound using split- or full-thickness autografts is the gold standard, permanent closure of larger defects may not be immediately feasible, especially if the presence of large burns limits the availability of donor sites. Newer temporary and permanent membranes can serve as adjuncts in some cases. Someday, burn surgeons may be in a position to close virtually any wound they generate using an immediately available, permanent, synthetic or laboratory-derived autologous composite.