دورية أكاديمية
أعرض في EDS

A Comparative Analysis of the Outcomes of Various Graft Types in Burn Reconstruction Over the Past 24 Years: A Systematic Review.

التفاصيل البيبلوغرافية
العنوان: A Comparative Analysis of the Outcomes of Various Graft Types in Burn Reconstruction Over the Past 24 Years: A Systematic Review.
المؤلفون: Aleman Paredes K; Surgery, Hospital General Regional No. 220 ¨Jose Vicente Villada¨, Toluca, MEX., Selaya Rojas JC; Plastic and Reconstructive Surgery, Hospital General Regional No. 220 ¨José Vicente Villada¨, Toluca, MEX., Flores Valdés JR; General Medicine, Universidad Autonoma de Guadalajara, Guadalajara, MEX., Castillo JL; General Medicine, Universidad Autonoma de Guadalajara, Guadalajara, MEX., Montelongo Quevedo M; General Medicine, Universidad Autonoma de Guadalajara, Guadalajara, MEX., Mijangos Delgado FJ; Surgery, Hospital General Regional No. 220 ¨José Vicente Villada¨, Toluca, MEX., de la Cruz Durán HA; Surgery, Hospital General Regional No. 220 ¨José Vicente Villada¨, Toluca, MEX., Nolasco Mendoza CL; Surgery, Hospital General Regional No. 220 ¨José Vicente Villada¨, Toluca, MEX., Nuñez Vazquez EJ; Surgery, Hospital General Regional No. 46, Guadalajara, MEX.
المصدر: Cureus [Cureus] 2024 Feb 15; Vol. 16 (2), pp. e54277. Date of Electronic Publication: 2024 Feb 15 (Print Publication: 2024).
نوع المنشور: Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: Cureus, Inc Country of Publication: United States NLM ID: 101596737 Publication Model: eCollection Cited Medium: Print ISSN: 2168-8184 (Print) Linking ISSN: 21688184 NLM ISO Abbreviation: Cureus Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Palo Alto, CA : Cureus, Inc.
مستخلص: Burn injuries, a major global health concern, result in an estimated 180,000 fatalities annually. Despite tremendous progress in treatment methods over the years, the morbidity and mortality associated with burns remain significant. Autologous skin grafting, particularly split-thickness skin grafting (STSG), has been a cornerstone in burn reconstruction, and it has facilitated survival and functional recovery for total body surface area (TBSA) significantly. However, the requirement for primary closure at the donor site due to the constraints of full-thickness donor harvesting continues to pose challenges. The introduction of dermal regenerative templates (DRT) in the late 1970s marked a substantial step forward in tissue engineering, addressing the inadequacy of dermal replacement with STSGs. This systematic review aimed to compare the outcomes of different graft types - bioengineered, autografts, allografts, and xenografts - in burn reconstruction over the last 24 years. The review focused on the pros and cons of each graft type, offering clinical insights grounded in experience and evidence. The approach involved a systematic review of studies published in English from January 2000 to January 2024, covering randomized controlled trials (RCTs), cohort studies, case-control studies, and case series. The participants comprised individuals of all ages who underwent burn reconstruction with skin grafts, specifically split-thickness grafts, full-thickness grafts, composite grafts, and epidermal grafts (autografts, allografts, and xenografts) and bioengineered grafts. The primary outcomes were functional and cosmetic results, patient satisfaction, graft survival, and complications. The risk of bias was evaluated using the Cochrane risk-of-bias tool for randomized trials version 2 (RoB 2), the Newcastle-Ottawa Scale (NOS) for non-randomized studies, and the Canada Institute for Health Economics (IHE) quality appraisal tool for case series. Our initial search yielded a total of 1,995 articles, out of which 10 studies were selected for final analysis. Among the four clinical trials assessed, 75% showed a high risk of bias. The studies reviewed involved various graft types, with six studies (60%) concentrating on allografts, three (30%) on autografts, and one (10%) on bioengineered skin grafts. The outcomes were varied, underlining the intricate nature of burn wound management. Our evaluation revealed promising results for autologous-engineered skin substitutes and allografts but also highlighted methodological disparities among the studies included. The dominance of observational studies and the diversity of outcome measures present obstacles to direct comparisons. Future research should address these limitations, employing well-structured RCTs, standardized outcome measures, and exploring long-term outcomes and patient-specific factors. The rapidly evolving field of regenerative medicine offers great potential for novel grafting methods. This systematic review provides valuable insights into the diverse outcomes of burn reconstruction using different graft types. Autologous-engineered skin substitutes and allografts seem to hold significant promise, suggesting a possible shift in grafting techniques. However, methodological inconsistencies and the lack of high-quality evidence underscore the necessity for further research to fine-tune burn care approaches.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2024, Aleman Paredes et al.)
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فهرسة مساهمة: Keywords: autograft harvesting technology; burn reconstruction; plastic and reconstructive surgery; skin burn; skin graft
تواريخ الأحداث: Date Created: 20240318 Latest Revision: 20240319
رمز التحديث: 20240319
مُعرف محوري في PubMed: PMC10944562
DOI: 10.7759/cureus.54277
PMID: 38496152
قاعدة البيانات: MEDLINE
الوصف
تدمد:2168-8184
DOI:10.7759/cureus.54277