In the past half century, the basic research and clinical treatment of burn surgery have developed rapidly and made a qualitative leap. It can be considered that in this process, the development of burn surgery has experienced two breakthrough revolutions. The first one was represented by the successful treatment of patients with large deep burns at the end of the 1950s in China, which broke the boundary of incurability for cases with burns exceeding 80% of the body surface area and created a precedent of successful rescue of burns over 90% of the body surface area. Since then, with the deepening of basic research and the accumulation of clinical experience, a relatively complete set of treatment plans for severe burns in line with China’s national conditions has been summed up, which has improved the cure rate of large burns, and the treatment level of many units is in the leading position in the world. The second time is marked by the concept of so-called systematic treatment and rehabilitation, which emerged in the 1980s, emphasizing the improvement of patients’ quality of life on the basis of saving lives, the early application of cosmetic principles and techniques to treat deep burn wounds, and the application of comprehensive rehabilitation techniques combined with body therapy, skin care and physiotherapy, so that some functions of patients with large deep burns can be improved or restored. However, it must be soberly recognized that the final results of treatment for severe burns are still far from people’s expectations. Poor appearance, function and severe pain caused by scar growth and contracture have always troubled patients and clinicians. People are looking forward to a new breakthrough. It is expected that the “restoration” type of recovery after the disfigurement of the main character in the movie will become a reality. To achieve this breakthrough, the author believes that one of the key issues is to make breakthroughs in the research of skin substitutes. 1, the current situation of skin substitutes for large deep burns 1, large allogeneic skin combined with autologous skin grafts to cover large deep burn wounds: autologous skin grafts are the most common method of treating deep burn wounds, and the purpose of skin implants is to rebuild the skin structure of the burn site and restore its appearance and function. To obtain this result, both the epidermis and the dermis, which constitute the skin, must be included. One of the major limitations in the treatment of deep burns, especially those with more than 50% of body surface area, is the lack of autologous skin sources. The first method of transplanting small pieces of autologous skin by drilling holes in large allogeneic skin, and the method of transplanting a mixture of large allogeneic skin and autologous microdermis has effectively solved the problem of early coverage of large deep burn wounds by the limited autologous skin. However, as far as the current situation of allograft skin is concerned, this method has its disadvantages that should not be ignored: (1) it is difficult to completely remove the possibility of hepatitis virus and HIV transmission from allograft skin; (2) the source of allograft skin is greatly restricted; (3) there are problems of rejection, aggravation of the disease when the rejection tissue is crusted, and the remaining wounds need to be covered by multiple implants; (4) scar growth is heavy after wound healing, and the appearance and function are poor. 2, pig skin combined with autologous skin grafts to cover large deep burns: In addition to the temporary application of allogeneic skin to cover large deep burns, there are also a variety of biological sources of allogeneic skin in the clinical application of burns. Because of the high homology between porcine and human and the wide availability and low price of porcine skin, fresh skin pieces containing epidermis and dermis, combined with autologous skin grafts, have been widely used to cover deep burn incision (scab) wounds, playing an important role for patients to survive infection crisis. However, because of the early rejection of pig skin and its inferiority to allogeneic skin, it is obviously not an ideal wound cover for large deep burns. 3, epidermal cell membrane sheet grafting to cover large deep burns: cultured epidermal cell membrane skin, there are applications for large deep burns wounds. The greatest advantage of this technique is that it can provide a large amount of epidermal membrane for transplantation with a small amount of skin, which provides a source of skin for patients with large deep burns who lack autologous skin and improves their chances of survival. However, it should not be overlooked that it only provides epidermis that simply covers the wound, so there are some problems with its survival and wound healing quality. For example, the membrane skin graft has poor local resistance to infection, low survival rate, brittle cellular membrane sheet, non-abrasion and non-extrusion resistance, easy to break, severe scar contracture later, and lack of dermal tissue structure characteristics. In addition, it takes 2 to 3 weeks to obtain a large number of autologous cells for skin grafting, which is often a loss of survival for a patient with large deep burns because the wound is not covered in time. Therefore, the application of cultured epidermal cell membrane sheets for early cut (scab) wound coverage and late scar growth in patients with large deep burns is far from the actual clinical requirements. 4, autologous thick skin combined with artificial dermal analogues, decellularized allogeneic, allogeneic dermal graft: in view of the autologous epidermal cell membrane is not the ideal skin substitute, as mentioned above, the ideal skin substitute should at least include epidermis and dermis, which can be applied to large deep burns not only in the early cut (cutting) scab wound coverage, and the late healing of the wound has the characteristics of nearly normal skin structure. The current application of autologous thick skin combined with dermal analogs, decellularized allografts, allogeneic dermal composite graft, this composite skin after the survival of the piece of skin contracture is light, small color change, flat appearance, no scar growth, soft to the touch, tough, good movement of joint parts. However, since the dermal substitute needs to be covered by autologous reimbursement, that is to say, how large an area of dermal substitute transplantation requires how large an area of autologous thick skin, which is almost impossible for a patient with large deep burns and an extremely scarce skin source. 5, autologous epidermal cell membrane combined with artificial dermal analogues, decellularized allogeneic (species) dermis transplantation: there is the application of cultured autologous epidermal cell membrane combined with dermal analogues, decellularized allogeneic, allogeneic dermis composite transplantation, which overcomes the poor local anti-infection ability of simple epidermal cell membrane transplantation, low graft survival rate, wound healing is not abrasion-resistant, easy to break down and other defects. At the same time, this composite graft greatly saves the autologous skin source and improves the appearance, but it is not compatible with clinical practice because it covers the early incision (scabbing) wounds of large deep burns, such as epidermal cell membrane sheets are not yet ready. Therefore, the cultured autologous epidermal cell membrane combined with dermal analogs and decellularized allogeneic (species) dermal composite grafts are not widely used in clinical practice because they are far from the actual coverage of early incision (cutting) scars of large deep burns. 6, genetically modified pig skin: through the genetic route to obtain skin substitutes, the key is not to play a permanent role. It has not yet been reported for clinical use in patients with large deep burns. The burn wounds are the basis of the pathophysiological changes of the body, the root cause of induced abnormal immune function, the main cause of hypermetabolism, and the direct source of infection. Surgical removal of burn scabs and closure of wounds can reduce bacterial invasion into the body, toxin absorption, wound infection, inflammatory mediators and other harmful substances that pose a threat to the body. It is now recognized that early scab removal and timely wound closure are one of the most critical and effective measures to improve the survival rate of patients with large deep burns. Thus, the quality of trauma coverings is directly related to the prognosis of patients with large deep burns. However, as mentioned above, the existing skin substitutes have their own advantages and disadvantages, some of them can cover large deep burn wounds early but the repair quality is poor, while others can achieve more satisfactory repair results but cannot achieve the purpose of early wound coverage. It is the direction of future research to make use of the advantages of existing skin substitutes and overcome their shortcomings. To achieve this goal, a possible model is to construct a permanent skin substitute by combining autologous and allogeneic epidermal cells and artificial dermal substitute with a shortened cell culture cycle, or to construct a dermal substitute by combining autologous epidermal stem cell culture-directed differentiation, in order to solve the real problems of scar growth, contracture, pain and itching, non-sweating, and functional impairment caused by the current deep burn scab wound coverage. The problem of scar growth, contracture, pain and itching, sweatlessness, and dysfunction caused by the current deep burn scab coverings.