Effect of Autologous Skin Cell Suspensions Versus Standard Treatment on Re-Epithelialization in Burn Injuries: A Meta-Analysis of RCTs.

Abstract

Background and Objectives: Burn injuries, particularly partial-thickness burns, often require advanced therapies to improve re-epithelialization and scar quality. This study aims to evaluate the efficacy of autologous skin cell suspensions, such as Recell, compared to standard treatments in promoting faster and better-quality skin healing. Our goal is to provide evidence-based conclusions on the effectiveness of these regenerative approaches in burn treatment. Materials and Methods: During our comprehensive investigation, we systematically examined several databases for the period to November 2024, including PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials. Our primary objective was to assess the efficacy of autologous cell suspension in treatment for burn injuries. We employed the ROB2 method to assess the quality of evidence to ensure the validity of the conclusions derived from these studies. The gathered data were systematically organized in a standardized online format and analyzed with RevMan 5.4. Results: Our systematic literature search identified nine studies (n = 358 patients) evaluating the efficacy of autologous skin cell suspensions in promoting re-epithelialization in burn injuries. The meta-analysis revealed a statistically significant reduction in time to re-epithelialization in the autologous skin cell suspension group compared to the control group (MD = -1.71 days, 95% CI [-2.73, -0.70], p = 0.001), with moderate heterogeneity among the studies (I² = 58%). However, no significant differences were found in secondary outcomes, including postoperative pain (SMD = -0.71, 95% CI [-2.42, 1.00], p = 0.42), POSAS scores (MD = -0.35, 95% CI [-2.12, 1.42], p = 0.69), Vancouver Scar Scale (MD = -0.76, 95% CI [-2.86, 1.33], p = 0.48), or the incidence of complete healing by the 4th week (RR = 0.98, 95% CI [0.94, 1.02], p = 0.24). Similarly, no significant differences were found in postoperative infection rates (RR = 0.85, 95% CI [0.28, 2.60], p = 0.78) or the need for further interventions (RR = 0.15, 95% CI [0.02, 1.16], p = 0.07). Conclusions: autologous skin cell suspension significantly reduces the time to re-epithelialization in burn injuries compared to standard treatments. However, no significant differences were found in secondary outcomes, such as postoperative pain, scar quality (POSAS, Vancouver Scar Scale), complete healing rates, infection rates, or the need for additional interventions. While autologous skin cell suspension shows promise in accelerating re-epithelialization, it does not provide significant advantages over conventional methods in other clinical aspects. The results underscore the need for further research with larger, more robust studies to assess the long-term benefits of autologous skin cell suspension in burns carefully.