Autologous Skin Grafts, versus Tissue-engineered Skin Constructs: A Systematic Review and Meta-analysis
Background:. For over 100 years, autologous skin grafts have remained the gold standard for the reconstruction of wounds but are limited in availability. Acellular tissue-engineered skin constructs (acellular TCs) and cellular tissue-engineered skin constructs (cellular TCs) may address these limita...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-06-01
|
| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005100 |
| _version_ | 1797792039717306368 |
|---|---|
| author | Sara Kianian, MTM, BA Kelley Zhao, BS Jasleen Kaur, BS Kimberly W. Lu, BS Sourish Rathi, BS Kanad Ghosh, MD, BA Hunter Rogoff, BS Thomas R. Hays, MD, BS Jason Park, MD Miriam Rafailovich, PhD Marcia Simon, PhD Duc T. Bui, MD Sami U. Khan, MD, FACS Alexander B. Dagum, MD, FACS, FRCS(C) Gurtej Singh, PhD |
| author_facet | Sara Kianian, MTM, BA Kelley Zhao, BS Jasleen Kaur, BS Kimberly W. Lu, BS Sourish Rathi, BS Kanad Ghosh, MD, BA Hunter Rogoff, BS Thomas R. Hays, MD, BS Jason Park, MD Miriam Rafailovich, PhD Marcia Simon, PhD Duc T. Bui, MD Sami U. Khan, MD, FACS Alexander B. Dagum, MD, FACS, FRCS(C) Gurtej Singh, PhD |
| author_sort | Sara Kianian, MTM, BA |
| collection | DOAJ |
| description | Background:. For over 100 years, autologous skin grafts have remained the gold standard for the reconstruction of wounds but are limited in availability. Acellular tissue-engineered skin constructs (acellular TCs) and cellular tissue-engineered skin constructs (cellular TCs) may address these limitations. This systematic review and meta-analysis compare outcomes between them.
Methods:. A systematic review was conducted using PRISMA guidelines, querying MEDLINE, Embase, Web of Science, and Cochrane to assess graft incorporation, failure, and wound healing. Case reports/series, reviews, in vitro/in vivo work, non-English articles or articles without full text were excluded.
Results:. Sixty-six articles encompassing 4076 patients were included. No significant differences were found between graft failure rates (P = 0.07) and mean difference of percent reepithelialization (p = 0.92) when split-thickness skin grafts were applied alone versus co-grafted with acellular TCs. Similar mean Vancouver Scar Scale was found for these two groups (p = 0.09). Twenty-one studies used at least one cellular TC. Weighted averages from pooled results did not reveal statistically significant differences in mean reepithelialization or failure rates for epidermal cellular TCs compared with split-thickness skin grafts (p = 0.55).
Conclusions:. This systematic review is the first to illustrate comparable functional and wound healing outcomes between split-thickness skin grafts alone and those co-grafted with acellular TCs. The use of cellular TCs seems promising from preliminary findings. However, these results are limited in clinical applicability due to the heterogeneity of study data, and further level 1 evidence is required to determine the safety and efficacy of these constructs. |
| first_indexed | 2024-03-13T02:27:22Z |
| format | Article |
| id | doaj.art-b5348291d9334f64abfedd946bdb2fcc |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-13T02:27:22Z |
| publishDate | 2023-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-b5348291d9334f64abfedd946bdb2fcc2023-06-30T01:49:20ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-06-01116e510010.1097/GOX.0000000000005100202306000-00061Autologous Skin Grafts, versus Tissue-engineered Skin Constructs: A Systematic Review and Meta-analysisSara Kianian, MTM, BA0Kelley Zhao, BS1Jasleen Kaur, BS2Kimberly W. Lu, BS3Sourish Rathi, BS4Kanad Ghosh, MD, BA5Hunter Rogoff, BS6Thomas R. Hays, MD, BS7Jason Park, MD8Miriam Rafailovich, PhD9Marcia Simon, PhD10Duc T. Bui, MD11Sami U. Khan, MD, FACS12Alexander B. Dagum, MD, FACS, FRCS(C)13Gurtej Singh, PhD14From the * Renaissance School of Medicine at Stony Brook University, Stony Brook, N.Y.From the * Renaissance School of Medicine at Stony Brook University, Stony Brook, N.Y.† Stony Brook University, Stony Brook, N.Y.† Stony Brook University, Stony Brook, N.Y.† Stony Brook University, Stony Brook, N.Y.From the * Renaissance School of Medicine at Stony Brook University, Stony Brook, N.Y.From the * Renaissance School of Medicine at Stony Brook University, Stony Brook, N.Y.From the * Renaissance School of Medicine at Stony Brook University, Stony Brook, N.Y.¶ Waterbury Hospital, Waterbury, Conn.‖ Department of Materials Science and Chemical Engineering, Stony Brook University Medical Center, Stony Brook, N.Y.** Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, N.Y.From the * Renaissance School of Medicine at Stony Brook University, Stony Brook, N.Y.From the * Renaissance School of Medicine at Stony Brook University, Stony Brook, N.Y.†† Division of Plastic and Reconstructive Surgery, Department of Surgery, Stony Brook University, Stony Brook, N.Y. Email: gurtej.singh@stonybrookmedicine.eduFrom the * Renaissance School of Medicine at Stony Brook University, Stony Brook, N.Y.Background:. For over 100 years, autologous skin grafts have remained the gold standard for the reconstruction of wounds but are limited in availability. Acellular tissue-engineered skin constructs (acellular TCs) and cellular tissue-engineered skin constructs (cellular TCs) may address these limitations. This systematic review and meta-analysis compare outcomes between them. Methods:. A systematic review was conducted using PRISMA guidelines, querying MEDLINE, Embase, Web of Science, and Cochrane to assess graft incorporation, failure, and wound healing. Case reports/series, reviews, in vitro/in vivo work, non-English articles or articles without full text were excluded. Results:. Sixty-six articles encompassing 4076 patients were included. No significant differences were found between graft failure rates (P = 0.07) and mean difference of percent reepithelialization (p = 0.92) when split-thickness skin grafts were applied alone versus co-grafted with acellular TCs. Similar mean Vancouver Scar Scale was found for these two groups (p = 0.09). Twenty-one studies used at least one cellular TC. Weighted averages from pooled results did not reveal statistically significant differences in mean reepithelialization or failure rates for epidermal cellular TCs compared with split-thickness skin grafts (p = 0.55). Conclusions:. This systematic review is the first to illustrate comparable functional and wound healing outcomes between split-thickness skin grafts alone and those co-grafted with acellular TCs. The use of cellular TCs seems promising from preliminary findings. However, these results are limited in clinical applicability due to the heterogeneity of study data, and further level 1 evidence is required to determine the safety and efficacy of these constructs.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005100 |
| spellingShingle | Sara Kianian, MTM, BA Kelley Zhao, BS Jasleen Kaur, BS Kimberly W. Lu, BS Sourish Rathi, BS Kanad Ghosh, MD, BA Hunter Rogoff, BS Thomas R. Hays, MD, BS Jason Park, MD Miriam Rafailovich, PhD Marcia Simon, PhD Duc T. Bui, MD Sami U. Khan, MD, FACS Alexander B. Dagum, MD, FACS, FRCS(C) Gurtej Singh, PhD Autologous Skin Grafts, versus Tissue-engineered Skin Constructs: A Systematic Review and Meta-analysis Plastic and Reconstructive Surgery, Global Open |
| title | Autologous Skin Grafts, versus Tissue-engineered Skin Constructs: A Systematic Review and Meta-analysis |
| title_full | Autologous Skin Grafts, versus Tissue-engineered Skin Constructs: A Systematic Review and Meta-analysis |
| title_fullStr | Autologous Skin Grafts, versus Tissue-engineered Skin Constructs: A Systematic Review and Meta-analysis |
| title_full_unstemmed | Autologous Skin Grafts, versus Tissue-engineered Skin Constructs: A Systematic Review and Meta-analysis |
| title_short | Autologous Skin Grafts, versus Tissue-engineered Skin Constructs: A Systematic Review and Meta-analysis |
| title_sort | autologous skin grafts versus tissue engineered skin constructs a systematic review and meta analysis |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005100 |
| work_keys_str_mv | AT sarakianianmtmba autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT kelleyzhaobs autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT jasleenkaurbs autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT kimberlywlubs autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT sourishrathibs autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT kanadghoshmdba autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT hunterrogoffbs autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT thomasrhaysmdbs autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT jasonparkmd autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT miriamrafailovichphd autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT marciasimonphd autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT ductbuimd autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT samiukhanmdfacs autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT alexanderbdagummdfacsfrcsc autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis AT gurtejsinghphd autologousskingraftsversustissueengineeredskinconstructsasystematicreviewandmetaanalysis |