New generation of skin substitutes gives hope to severe burn patients

Severe burns remain one of the most challenging injuries to treat, causing high disease and death rates worldwide, but Australian researchers have flagged some promising new approaches that could save lives and dramatically improve patient recovery.

In a comprehensive review published in Advanced Therapeutics, researchers from the University of South Australia (UniSA), University of Adelaide and Royal Adelaide Hospital (RAH) explore the latest advancements in dermal substitutes—biochemicals used to replace damaged skin—with a particular focus on combating infection and enhancing tissue regeneration following catastrophic burns.

The researchers say that despite decades of progress, traditional treatments such as skin grafting often fail to provide adequate healing and infection control, leading to prolonged hospital stays and soaring health care costs.

According to the lead authors Dr. Zlatko Kopecki and Dr. Bronwyn Dearman, the urgency to develop safer, more effective solutions has never been greater.

“Infections are a major cause of complications and mortality in burn patients,” says Dr. Kopecki, a Research Fellow at UniSA’s Future Industries Institute. “We must innovate beyond conventional methods and develop therapies that regenerate tissue while actively preventing infections.”

Each year, approximately 2,423 Australians are admitted to hospital with burn-related injuries, 74% of whom require surgery, including a skin graft. Globally, 180,000 people die from burns each year, and approximately 10 million are hospitalized, costing health care systems $112 billion worldwide.

The review highlights that while many commercial skin substitutes exist, very few offer integrated antimicrobial protection—a critical factor given the vulnerability of burn wounds to bacterial invasion and sepsis.

The paper discusses emerging technologies such as Kerecis, a novel fish skin graft with inherent antimicrobial properties, and NovoSorb BTM, a synthetic biodegradable matrix that resists bacterial colonization without relying on antibiotics.

Both products represent a new generation of dermal substitutes with enhanced potential to protect and heal complex burns.

Kerecis comes from wild Atlantic cod, caught from a sustainable fish stock in pristine Icelandic waters and processed using renewable energy. It stands out for retaining natural omega-3 fatty acids, which have strong antimicrobial effects and promote wound healing.

Meanwhile, NovoSorb BTM’s unique polyurethane matrix offers structural resilience even in infected wounds, providing a vital scaffold for tissue regeneration.

“These materials demonstrate a shift towards multifunctional therapies that combine structural support with infection resistance,” says Dr. Dearman, Principal Medical Scientist for the Skin Engineering Laboratory at the RAH and an Adjunct Lecturer at the University of Adelaide.

“Such innovations are crucial, particularly as antibiotic-resistant infections continue to rise globally,” she says.

The review calls for the next wave of research to integrate active antimicrobial agents directly into 3D dermal scaffolds that support cell growth, reducing the reliance on antibiotics and temporary dressings.

Beyond infection control, the research points to scarless healing as the future frontier of burn care.

By combining smart biomaterials with cell-based therapies, scientists aim to regenerate skin that restores its full function—an outcome that could revolutionize the recovery for millions of burn survivors worldwide.

The research team includes experts from the Future Industries Institute at UniSA, the Adult Burn Service at the Royal Adelaide Hospital, and the Faculty of Health and Medical Sciences at the University of Adelaide.