A living chimeric skin replacement

The invention comprises skin replacements for improved wound healing. In one embodiment, the skin replacement is chimeric and comprises harvesting autologous epithelial cells from a patient and seeding them onto a biocompatible substrate containing allogeneic epithelial cells cultured in vitro. The living chimeric skin replacement may be implanted over a permanent dermal replacement previously implanted at the wound site. In another embodiment the skin replacement is a composite comprising an inner, middle and outer component, comprising (a) an inner component comprising a biocompatible dermal construct having a biodegradable or removable scaffold as a base; (b) a middle component comprising epithelial cells; and (c) an outer component comprising epithelial cells cultured in vitro on a dermal construct comprising a dermal portion having a biodegradable or removable scaffold as a base, said dermal portion being combined with a transitional covering and facing inward toward said middle component of epithelial cells. The invention further comprises methods of making and implanting the various skin replacements of the invention.