Pham C, Greenwood J, Cleland H, Woodruff P, Maddern G, et al.
Burns : journal of the International Society for Burn Injuries. Date of publication 2007 Dec 1;volume 33(8):946-57.
1. Burns. 2007 Dec;33(8):946-57. Epub 2007 Sep 7.
Bioengineered skin substitutes for the management of burns: a systematic review.
Pham C(1), Greenwood J, Cleland H, Woodruff P, Maddern G.
Author information:
(1)ASERNIP-S, Royal Australasian College of Surgeons, and Burns Unit, Royal
Adelaide Hospital, South Australia, Australia.
OBJECTIVE: To assess the safety and efficacy of bioengineered skin substitutes in
comparison with biological skin replacements and/or standard dressing methods in
the management of burns, through a systematic review of the literature.
METHODS: Literature databases were searched up to April 2006, identifying
randomised controlled trials.
RESULTS: Twenty randomised controlled trials were included in this review. The
numerous sub-group analyses and the diversity of skin substitutes limited the
ability to draw any conclusions from it. However, the evidence suggested that
bioengineered skin substitutes, namely Biobrane, TransCyte, Dermagraft, Apligraf,
autologous cultured skin, and allogeneic cultured skin, were at least as safe as
biological skin replacements or topical agents/wound dressings. The safety of
Integra could not be determined. For the management of partial thickness burns,
the evidence suggested that bioengineered skin substitutes, namely Biobrane,
TransCyte, Dermagraft, and allogeneic cultured skin, were at least as efficacious
as topical agents/wound dressings or allograft. Apligraf combined with autograft
was at least as efficacious as autograft alone. For the management of full
thickness burns, the efficacy of autologous cultured skin could not be determined
based on the available evidence. The efficacy of Integra could not be determined
based on the available evidence.
CONCLUSIONS: Additional methodologically rigorous randomised controlled trials
with long-term follow-up would strengthen the evidence base for the use of
bioengineered skin substitutes.
DOI: 10.1016/j.burns.2007.03.020
PMID: 17825993 [Indexed for MEDLINE]
