Hautersatzverfahren in der Verbrennungschirurgie

Patients with extensive deep partial or full thickness burns require early excision of necrotic tissue, however, in many of these cases simultaneous autografting is not possible due to the general condition of the patient. In this instance temporary dressings like allogeneic or xenogeneic skin or foam dressings can be applied to minimize fluid and protein loss. In Europe glycerolized preserved allogeneic skin remains the treatment standard. Dermal replacements are considered to optimize the long-term outcome of split thickness skin grafting. Reduced contracture rates and increased pliability have been reported after additional dermal enhancement with either collagen-glycosaminoglycan matrix, acellular allogeneic dermis or collagen/elastin matrix. True regeneration of the dermis has not yet been observed. However, these materials are suitable for improvement of the wound bed and also the final result after split thickness skin transplantation.