A systematic review and meta-analysis of randomized trials evaluating the efficacy of autologous skin cell suspensions for re-epithelialization of acute partial thickness burn injuries and split-thickness skin graft donor sites.


Journal

Burns : journal of the International Society for Burn Injuries
ISSN: 1879-1409
Titre abrégé: Burns
Pays: Netherlands
ID NLM: 8913178

Informations de publication

Date de publication:
09 2021
Historique:
received: 04 07 2020
revised: 20 12 2020
accepted: 06 04 2021
pubmed: 5 5 2021
medline: 22 12 2021
entrez: 4 5 2021
Statut: ppublish

Résumé

This systematic review evaluated the efficacy of autologous skin cell suspensions (ASCS) on the re-epithelialization of partial thickness burn injuries and skin graft donor site wounds. Four databases (EMBASE, Google Scholar, MEDLINE, Web of Science), grey literature and select journal hand-searching identified studies from 1975 - 2020. Randomized trials evaluating partial thickness burn management with non-cultured ASCS compared to any other intervention were included. Time to re-epithelialization (TTRE) was the primary outcome. Three independent researchers completed screening, data extraction and certainty of evidence assessment using Cochrane Risk of Bias Tool and Grading of Recommendations Assessment, Development and Evaluation. Five trials (n = 347) reported on adults (2 trials) and children (1 trial) with burn wounds, and adults with donor site wounds (2 trials). The effect of ASCS compared to control on TTRE in adult burn wounds was not estimable. TTRE was shorter in pediatric burn wounds (SMD -1.75 [95% CI: -3.45 to -0.05]) and adult donor site wounds (SMD-5.71 [95% CI: -10.61 to-0.81]) treated with ASCS. The certainty of evidence was very low. Compared to standard care, ACSC may reduce pediatric partial thickness burn wound and adult split-thickness skin graft donor site TTRE. PROSPERO CRD42019133171.

Sections du résumé

BACKGROUND
This systematic review evaluated the efficacy of autologous skin cell suspensions (ASCS) on the re-epithelialization of partial thickness burn injuries and skin graft donor site wounds.
METHODS
Four databases (EMBASE, Google Scholar, MEDLINE, Web of Science), grey literature and select journal hand-searching identified studies from 1975 - 2020. Randomized trials evaluating partial thickness burn management with non-cultured ASCS compared to any other intervention were included. Time to re-epithelialization (TTRE) was the primary outcome. Three independent researchers completed screening, data extraction and certainty of evidence assessment using Cochrane Risk of Bias Tool and Grading of Recommendations Assessment, Development and Evaluation.
RESULTS
Five trials (n = 347) reported on adults (2 trials) and children (1 trial) with burn wounds, and adults with donor site wounds (2 trials). The effect of ASCS compared to control on TTRE in adult burn wounds was not estimable. TTRE was shorter in pediatric burn wounds (SMD -1.75 [95% CI: -3.45 to -0.05]) and adult donor site wounds (SMD-5.71 [95% CI: -10.61 to-0.81]) treated with ASCS. The certainty of evidence was very low.
CONCLUSION
Compared to standard care, ACSC may reduce pediatric partial thickness burn wound and adult split-thickness skin graft donor site TTRE.
REGISTRATION
PROSPERO CRD42019133171.

Identifiants

pubmed: 33941398
pii: S0305-4179(21)00086-3
doi: 10.1016/j.burns.2021.04.005
pii:
doi:

Substances chimiques

Suspensions 0

Types de publication

Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1225-1240

Commentaires et corrections

Type : CommentIn

Informations de copyright

Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved.

Auteurs

Anjana Bairagi (A)

Centre for Children's Burns and Trauma Research, Centre for Children's Health Research and Pegg Leditschke Children's Burns Centre, Queensland Children's Hospital, Brisbane, Queensland, Australia; Queensland University of Technology, Burns and Trauma Research, Centre for Children's Health Research, Brisbane, Queensland, Australia. Electronic address: a.bairagi@qut.edu.au.

Bronwyn Griffin (B)

Centre for Children's Burns and Trauma Research, Centre for Children's Health Research and Pegg Leditschke Children's Burns Centre, Queensland Children's Hospital, Brisbane, Queensland, Australia; Queensland University of Technology, Burns and Trauma Research, Centre for Children's Health Research, Brisbane, Queensland, Australia; National Health and Medical Research Council Centre of Research Excellence - Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.. Electronic address: bronwyn.griffin@griffith.edu.au.

Tara Banani (T)

The University of Queensland, Centre for Children's Burns and Trauma Research, Children's Health Research Centre, Brisbane, Queensland, Australia. Electronic address: t.banani@uq.edu.au.

Steven M McPhail (SM)

Queensland University of Technology, Australian Centre for Health Service Innovation and Centre for Healthcare Transformation, Brisbane, Queensland, Australia; Metro South Hospital and Health Service, Clinical Informatics Directorate, Brisbane, Queensland, Australia. Electronic address: steven.mcphail@qut.edu.au.

Roy Kimble (R)

Centre for Children's Burns and Trauma Research, Centre for Children's Health Research and Pegg Leditschke Children's Burns Centre, Queensland Children's Hospital, Brisbane, Queensland, Australia; Queensland University of Technology, Burns and Trauma Research, Centre for Children's Health Research, Brisbane, Queensland, Australia; The University of Queensland, Centre for Children's Burns and Trauma Research, Children's Health Research Centre, Brisbane, Queensland, Australia. Electronic address: royk@uq.edu.au.

Zephanie Tyack (Z)

Centre for Children's Burns and Trauma Research, Centre for Children's Health Research and Pegg Leditschke Children's Burns Centre, Queensland Children's Hospital, Brisbane, Queensland, Australia; The University of Queensland, Centre for Children's Burns and Trauma Research, Children's Health Research Centre, Brisbane, Queensland, Australia; Queensland University of Technology, Australian Centre for Health Service Innovation and Centre for Healthcare Transformation, Brisbane, Queensland, Australia; Metro South Hospital and Health Service, Clinical Informatics Directorate, Brisbane, Queensland, Australia. Electronic address: z.tyack@qut.edu.au.

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Classifications MeSH