The added value of cultured cells in burn treatment: A systematic review

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns Pub Date : 2024-08-16 DOI:10.1016/j.burns.2024.08.013

Marie Simaey, Ignace De Decker, Florian Vanlauwe, Phillip Blondeel, Stan Monstrey, Karel E.Y. Claes

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引用次数: 0

Abstract

Advancements in resuscitative care and burn surgery have improved survival rates after extensive burn injuries, shifting focus to enhancing the quality of survival. Conventional treatment with split-thickness skin grafts (STSG) presents limitations like donor-site morbidity, limited availability in extensive burn injuries, and hypertrophic scarring (HTS). Tissue engineering aims to address these drawbacks by developing optimal skin substitutes. This systematic review aims to provide an overview of the current applications of cultured cells in burn surgery, encompassing diverse approaches and addressing existing challenges to enhance burn wound management and improve patient outcomes. Following PRISMA guidelines, a comprehensive search was performed across three databases (PubMed, Embase, Cochrane Library) for articles on cultured cell use in burn treatment. Only clinical studies were included. Articles were screened by two independent reviewers. Quality assessment was performed. The search yielded 167 articles of which 14 met the eligibility criteria. The selection included 8 randomized controlled trials (RCT), 5 prospective cohort trials, and 1 retrospective cohort study. Various tissue-engineered skin substitutes, from cultured epidermal autografts (CEA) to dermal regeneration templates (DRT) seeded with cultured cells, showed promising outcomes. Several substitutes exhibited take rates comparable to STSG with improved scar quality. Results are promising, though standardization of cultured skin substitutes and robust clinical trials with larger populations and appropriate comparators are still lacking.

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培养细胞在烧伤治疗中的附加值：系统综述

复苏护理和烧伤外科的进步提高了大面积烧伤后的存活率，并将重点转移到提高存活质量上。传统的分层厚皮移植术（STSG）存在供皮部位发病率高、在大面积烧伤中可用性有限以及增生性瘢痕（HTS）等局限性。组织工程学旨在通过开发最佳皮肤替代品来解决这些问题。本系统性综述旨在概述目前烧伤外科中培养细胞的应用，包括各种方法，并解决现有的挑战，以加强烧伤创面管理并改善患者预后。根据 PRISMA 指南，我们在三个数据库（PubMed、Embase、Cochrane Library）中对有关培养细胞用于烧伤治疗的文章进行了全面检索。仅纳入临床研究。文章由两名独立审稿人进行筛选。并进行了质量评估。检索结果显示，共有 167 篇文章，其中 14 篇符合资格标准。其中包括 8 项随机对照试验 (RCT)、5 项前瞻性队列试验和 1 项回顾性队列研究。从培养表皮自体移植物（CEA）到播种了培养细胞的真皮再生模板（DRT）等各种组织工程皮肤替代品都显示出良好的效果。几种替代品的取材率与 STSG 相当，疤痕质量也有所改善。虽然目前还缺乏对培养皮肤替代品的标准化研究，也没有进行更大规模的临床试验和适当的比较试验，但这些结果还是很有希望的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Burns 医学-皮肤病学

CiteScore

4.50

自引率

18.50%

发文量

304

审稿时长

72 days

期刊介绍： Burns aims to foster the exchange of information among all engaged in preventing and treating the effects of burns. The journal focuses on clinical, scientific and social aspects of these injuries and covers the prevention of the injury, the epidemiology of such injuries and all aspects of treatment including development of new techniques and technologies and verification of existing ones. Regular features include clinical and scientific papers, state of the art reviews and descriptions of burn-care in practice. Topics covered by Burns include: the effects of smoke on man and animals, their tissues and cells; the responses to and treatment of patients and animals with chemical injuries to the skin; the biological and clinical effects of cold injuries; surgical techniques which are, or may be relevant to the treatment of burned patients during the acute or reconstructive phase following injury; well controlled laboratory studies of the effectiveness of anti-microbial agents on infection and new materials on scarring and healing; inflammatory responses to injury, effectiveness of related agents and other compounds used to modify the physiological and cellular responses to the injury; experimental studies of burns and the outcome of burn wound healing; regenerative medicine concerning the skin.