Ideal skin substitutes would reproduce normal skin in its various functions. Even in the absence of such ultimate products, the ones in use today represent a major part in local burn care as agents promoting wound healing and minimising the long-term consequences after burn injuries. They originate from natural structures as well as (bio)engineering concepts. The application fields cover all depth of burns as well as skin donors' areas and even secondary surgery. Among other techniques, skin allografts followed by autografts or autologous keratinocytes cultures especially over the integrated dermis and artificial skin Integra then subsequently grafted with very thin autografts are significant methods in treating extensive injuries when utilised according to clinical status accurately defined. However further advances are essential for improving the life of burn survivors.