Efficacy of Acellular Dermal Matrix in Improving Clinical Outcomes in Pediatric Burns: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Background

This latest systematic review and meta-analysis aim to examine the efficacy of acellular dermal matrix (ADM) in pediatric burns.

Methods

Relevant articles were retrieved from Pubmed, Embase, Cochrane, Web of science, China National Knowledge Infrastructureris, VIP Database for Chinese Technical Periodicals and Wanfang database. The primary outcome was the healing time, and secondary outcomes were the skin graft survival rate, reoperation, complications, numbers of dressing change, incidence of scarring, scar areas and scar scores. Data were pooled and expressed as relative risk (RR), mean difference (MD) and standardized mean difference (SMD) with a 95 % confidence interval (CI).

Results

12 studies with 884 patients were included in this systematic review and meta-analysis. The pooled data from all included studies demonstrated that the patients who have applied ADM treatment had significantly reduced healing time (MD = −3.13; 95 % CI: −4.99 to −1.26; p < 0.001, I² = 94.0 %), complications (RR = 0.40; 95 % CI: 0.20–0.79, p = 0.008, I² = 25 %), numbers of dressing change (MD = −4.41; 95 % CI: −7.46 to −1.37, p = 0.005, I² = 97 %) and incidence of scarring (RR = 0.38; 95 % CI: 0.18–0.78, p = 0.009, I² = 77 %) compared to those who have not applied ADM treatment. There were no significant differences in skin graft survival rate, reoperation, scar areas and scar scores between the two groups.

Conclusion

ADM may accelerate wound healing, reduce complications and dressing changes, and inhibit scarring in pediatric burns, however, due to the high level of heterogeneity and methodological differences among the included studies, these results should be interpreted with caution. Further research with standardized protocols and larger, more diverse patient populations is needed to confirm these findings.