Review Stem cell strategies in burns care A. Burd *, K. Ahmed, S. Lam, T. Ayyappan, L. Huang Division of Plastic & Reconstructive Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China Contents 1. Introduction .................................................................................. 282 2. Stem cells and skin tissue engineering ............................................................. 283 3. Stem cells and wound healing modulation.......................................................... 285 4. Clinical challenge ............................................................................. 285 5. Hypothesis ................................................................................... 287 6. Cord blood ................................................................................... 287 7. Stem cell fractions ............................................................................. 288 8. Summary .................................................................................... 288 Acknowledgements ............................................................................ 289 References ................................................................................... 289 1. Introduction The last 30 years has seen a tremendous evolution in conceptual strategies in the field of burns care. The three ‘R’’s, replace, reconstruct, regenerate have their clinical application in transplantation, tissue engineering and now, stem cells therapies [1]. When Rheinwald and Green described the serial cultivation of strains of human epidermal kerati- nocytes with the formation of keratinizing colonies from single cells over 30 years ago [2], naive claims were made by some laboratory scientists that the burns care of the future would be a simple matter of quick and easy cover after the excision of burn wounds. Unfortunately this is far from reality [3,4]. The next decade brought the concept of tissue engineering. When the term ‘tissue engineering’ was officially coined at a National Science Foundation Workshop in the USA in 1988, it was understood to mean ‘the application of principles and methods of engineering and life sciences toward the funda- mental understanding of structure–function relationships in burns 33 (2007) 282–291 article info Article history: Accepted 15 August 2006 Keywords: Stem cells Marrow suppression Burns abstract The prospect of being able to replace damaged tissue by the process of regeneration would dramatically and irrevocably change the impact, management and outcome of burns. The current understanding of stem cell-based modulation and therapy together with their potential developments do bring this prospect ever closer to a clinical reality. This paper gives a background to stem cell strategies in burns care and identifies actual or prospective applications which, collectively, will forever change burns care throughout the world. # 2006 Elsevier Ltd and ISBI. All rights reserved. * Corresponding author. Tel.: +852 2632 2639; fax: +852 2632 4675. E-mail address: andrewburd@surgery.cuhk.edu.hk (A. Burd). available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/burns 0305-4179/$30.00 # 2006 Elsevier Ltd and ISBI. All rights reserved. doi:10.1016/j.burns.2006.08.031