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. Issue 6 (September 2021)

• Record Type: Journal Article
• Authors: Bairagi, Anjana; Griffin, Bronwyn; Banani, Tara; McPhail, Steven M.; Kimble, Roy; Tyack, Zephanie
• Is Part Of: Burns. Volume 47:Issue 6(2021)
• Page Start: 1225
• Page End: 1240
• Publication Date: 2021-09
• Subjects: ASCS Autologous skin cell suspension -- BRACS Biobrane®, RECELL® Autologous Skin -- Cell Suspension and Silver Dressings -- B-TBSA burn total body surface area -- BW Burn Wound -- CI Confidence Interval -- CHIPPS Children and Infant's Post-operative Pain Scale -- CHU9D Child Health Utility 9D -- DSW Donor Site Wound -- EPOC Effective Practice and Organisation of Care -- FLACC Face, Legs, Activity, Cry, Consolability -- FPS-R Faces Pain Scale-Revised -- GRADE Grading of Recommendations Assessment, Development, and Evaluation -- HRQoL Health Related Quality of Life -- IQR Inter quartile range -- IV Inverse Variance -- OR Odds Ratio -- POSAS Patient and Observer Scar Assessment Scale -- PRISMA Preferred Reporting Items for Systematic Review and Meta-Analysis -- RES™ Regenerative Epidermal Suspension -- SD Standard Deviation -- SMD Standardized Mean Difference -- SSG Split-thickness skin graft -- TiDieR Template for Intervention Description and Replication -- TTRE Time to Re-Epithelialization -- VAS Visual Analogue Scale -- VSS Vancouver Scar Scale -- WHO World Health Organisation; Epithelial cell suspension -- Child -- Donor site wound -- Autograft -- Dermal -- Burn -- Wound Healing; Burns and scalds -- Periodicals; 617.11
• DOI: 10.1016/j.burns.2021.04.005
• Languages: English
• ISSNs: 0305-4179

Abstract

Highlights: Time to re-epithelialization may be reduced with autologous skin cell suspensions. Most of the evidence was based on adult studies. The certainty of evidence was very low. Abstract: 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