Burn wound closure with cultured autologous keratinocytes and fibroblasts attached to a collagen-glycosaminoglycan substrate.

Improved survival of patients with extensive burn injuries requires the development of better techniques for timely and permanent closure of the full-thickness wound. We developed procedures for establishing confluent, stratified layers of cultured, autologous keratinocytes on the surface of a modified collagen-glycosaminoglycan membrane that contains autologous fibroblasts. We transferred the composite grafts onto limited areas of excised full-thickness burn wounds of four patients with extensive burn injuries. Our results indicate that this composite graft material has acceptable "take," with formation of a basement membrane within 9 days of graft placement. Use of this technique for major wound coverage may offer a significant advance in the care of extensively burned patients and also may be useful for providing skin for reconstructive surgery.