皮肤替代物在烧伤和烧伤疤痕重建中的疗效:系统回顾和荟萃分析。

IF 3.8 3区 医学 Q2 CELL BIOLOGY
Wound Repair and Regeneration Pub Date : 2024-11-01 Epub Date: 2024-10-22 DOI:10.1111/wrr.13226
Anna S van den Bosch, Robin A F Verwilligen, Anouk Pijpe, Eelke Bosma, Cees H van der Vlies, Ymke Lucas, George L Burchell, Paul P M van Zuijlen, Esther Middelkoop
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引用次数: 0

摘要

真皮替代品已被引入烧伤护理领域,以改善伤口愈合效果;然而,在标准治疗中,真皮替代品的使用仍然有限。本系统综述和荟萃分析旨在评估真皮替代品在烧伤患者和需要烧伤疤痕重建患者中的疗效,进而促进真皮替代品与临床实践的优化结合,缩小知识差距。我们在各种数据库中进行了全面搜索,包括同行评审期刊中关于真皮替代品治疗真皮深层和全层烧伤以及各年龄段疤痕重建的人类研究。研究人员从比较试验中提取了数据,重点关注患者和伤口特征、治疗细节以及与伤口愈合和疤痕质量相关的结果。对报告了类似烧伤后测量结果的试验进行了 Meta 分析,并对统计异质性进行了评估。结果采用平均差异或几率比加 95% 置信区间表示。共纳入了 31 项比较试验。研究的总体质量被认为是中等。荟萃分析表明,在急性烧伤患者中,使用胶原蛋白-弹性蛋白基质治疗后 4-7 天,其再上皮化时间比分层厚皮移植延迟(-7.30%,p = 0.02)。在急性烧伤创面中,术后 6 个月使用非细胞真皮基质与分层厚皮移植相比,主观疤痕质量有明显改善(-1.95,p = 0.02)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes of dermal substitutes in burns and burn scar reconstruction: A systematic review and meta-analysis.

Dermal substitutes have been introduced in burn care to improve wound healing outcomes; however, their use remains limited in standard treatments. This systematic review and meta-analysis aimed to evaluate the outcomes of dermal substitutes in patients with burns and patients requiring burn scar reconstruction and subsequently contribute to optimising the integration of dermal substitutes into clinical practice and reducing the knowledge gap. A comprehensive search across various databases included human studies from peer-reviewed journals on dermal substitutes for deep dermal and full-thickness burns, and scar reconstruction across all ages. Data from comparative trials were extracted, focusing on patient and wound characteristics, treatment specifics, and outcomes related to wound healing and scar quality. Meta-analysis was performed on trials reporting similar post-burn measures, with statistical heterogeneity assessed. Outcomes were presented using mean differences or odds ratios with 95% confidence intervals. A total of 31 comparative trials were included. The overall quality of the studies was considered moderate. The meta-analysis indicated delayed re-epithelialization 4-7 days after treatment with a collagen-elastin matrix compared to split-thickness skin graft in acute burns (-7.30%, p = 0.02). Significant improvement in subjective scar quality was observed with acellular dermal matrix compared to split-thickness skin graft in acute burn wounds 6 months post-operative (-1.95, p <0.01). While acknowledging the initially delayed wound healing, incorporating dermal substitutes into the surgical treatment of burn patients holds promise for enhancing scar quality. However, future research must prioritise outcome measure uniformity, address variations in dermal substitute application, and standardise indications for consistent and effective practices.

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来源期刊
Wound Repair and Regeneration
Wound Repair and Regeneration 医学-皮肤病学
CiteScore
5.90
自引率
3.40%
发文量
71
审稿时长
6-12 weeks
期刊介绍: Wound Repair and Regeneration provides extensive international coverage of cellular and molecular biology, connective tissue, and biological mediator studies in the field of tissue repair and regeneration and serves a diverse audience of surgeons, plastic surgeons, dermatologists, biochemists, cell biologists, and others. Wound Repair and Regeneration is the official journal of The Wound Healing Society, The European Tissue Repair Society, The Japanese Society for Wound Healing, and The Australian Wound Management Association.
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