Die funktion von hautersatz bei der behandlung nicht heilender wunden

Non-healing wounds like venous-, arterial-, and diabetic ulcers are widespread and form a source of great discomfort, pain and disability in many patients. The health care costs mad e in managing these chronic skin defects are substantial. In this article various skin substitution methods for nonhealing wounds are reviewed and their advantages and limitations discussed. Products which are already on the market are weighed up the pros en cons. Firstly, wound coverage with autologous and allogeneic cultured epithelium is reviewed. The next part is focussed on 'full skin equivalents', combining cultured epithelium with: 1) porous collagenous substitutes, according to Yannas, 2) collagen lattices, according to Bell, 3) de- epidermidised dermis, according to Cuono and 4) non collagenous skin substitutes. The final part is focussed on new and possible future developments in skin substitution related research like genetically modified tissue and xenograft transplantation.