title: Epidermal healing in burns: autologous keratinocyte transplantation as a standard procedure: update and perspective.
abstract: BACKGROUND
  Treatment of burned patients is a tricky clinical problem not only because of the extent of the physiologic abnormalities but also because of the limited area of normal skin available.
  
  
  METHODS
  Literature indexed in the National Center (PubMed) has been reviewed using combinations of key words (burns, children, skin graft, tissue engineering, and keratinocyte grafts). Articles investigating the association between burns and graft therapeutic modalities have been considered. Further literature has been obtained by analysis of references listed in reviewed articles.
  
  
  RESULTS
  Severe burns are conventionally treated with split-thickness skin autografts. However, there are usually not enough skin donor sites. For years, the question of how covering the wound surface became one of the major challenges in clinical research area and several procedures were proposed. The microskin graft is one of the oldest methods to cover extensive burns. This technique of skin expansion is efficient, but results remain inconsistent. An alternative is to graft cultured human epidermal keratinocytes. However, because of several complications and labor-intensive process of preparing grafts, the initial optimism for cultured epithelial autograft has gradually declined. In an effort to solve these drawbacks, isolated epithelial cells from selecting donor site were introduced in skin transplantation.
  
  
  CONCLUSIONS
  Cell suspensions transplanted directly to the wound is an attractive process, removing the need for attachment to a membrane before transfer and avoiding one potential source of inefficiency. Choosing an optimal donor site containing cells with high proliferative capacity is essential for graft success in burns.
authors.affiliation: Pediatric Department, Service de Chirurgie Pédiatrique, CHU de Poitiers, Poitiers, France; pole biologie santé, LITEC, Laboratoire Inflammation, Tissus Epithéliaux et Cytokines EA 4331, Université de Poitiers, Poitiers, France; BIOalternatives, Gençay, France; and pole biospharm, Laboratoire d'immunologie et Inflammation, CHU de Poitiers, Poitiers, France.
authors.forename: Jiad N
authors.initials: JN
authors.lastname: Mcheik
authors.affiliation: Pediatric Department, Service de Chirurgie Pédiatrique, CHU de Poitiers, Poitiers, France; pole biologie santé, LITEC, Laboratoire Inflammation, Tissus Epithéliaux et Cytokines EA 4331, Université de Poitiers, Poitiers, France; BIOalternatives, Gençay, France; and pole biospharm, Laboratoire d'immunologie et Inflammation, CHU de Poitiers, Poitiers, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Barrault
authors.affiliation: Pediatric Department, Service de Chirurgie Pédiatrique, CHU de Poitiers, Poitiers, France; pole biologie santé, LITEC, Laboratoire Inflammation, Tissus Epithéliaux et Cytokines EA 4331, Université de Poitiers, Poitiers, France; BIOalternatives, Gençay, France; and pole biospharm, Laboratoire d'immunologie et Inflammation, CHU de Poitiers, Poitiers, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Levard
authors.affiliation: Pediatric Department, Service de Chirurgie Pédiatrique, CHU de Poitiers, Poitiers, France; pole biologie santé, LITEC, Laboratoire Inflammation, Tissus Epithéliaux et Cytokines EA 4331, Université de Poitiers, Poitiers, France; BIOalternatives, Gençay, France; and pole biospharm, Laboratoire d'immunologie et Inflammation, CHU de Poitiers, Poitiers, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Morel
authors.affiliation: Pediatric Department, Service de Chirurgie Pédiatrique, CHU de Poitiers, Poitiers, France; pole biologie santé, LITEC, Laboratoire Inflammation, Tissus Epithéliaux et Cytokines EA 4331, Université de Poitiers, Poitiers, France; BIOalternatives, Gençay, France; and pole biospharm, Laboratoire d'immunologie et Inflammation, CHU de Poitiers, Poitiers, France.
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Bernard
authors.affiliation: Pediatric Department, Service de Chirurgie Pédiatrique, CHU de Poitiers, Poitiers, France; pole biologie santé, LITEC, Laboratoire Inflammation, Tissus Epithéliaux et Cytokines EA 4331, Université de Poitiers, Poitiers, France; BIOalternatives, Gençay, France; and pole biospharm, Laboratoire d'immunologie et Inflammation, CHU de Poitiers, Poitiers, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Lecron