Les substituts cutanés reconstruits en laboratoire : application au traitement des brûlés

The development of skin substitutes started 25 years ago with the cultivation of keratinocytes to replace the epidermis of extensively burned patients. It is now possible to reproduce in vitro the two layers of skin, epidermis and dermis. Cultured epidermises are now usually used in burn centers dealing with the more severe patients. They are provided by hospital or private laboratories. Dermal substrates are some collagen matrices, which act in vivo as a guide for the reconstruction of a neodermis. Living dermis include living fibroblasts. Different models are now available for clinical use. Living skin equivalent is obtained by coculturing fibroblast and keratinocytes on a collagen support. Clinical essays are going on for chronic wounds. We present the different skin equivalent models and their clinical applications.