P126. a comparison of the clinical wound healing outcomes of autologous skin grafts and tissue-engineered skin constructs: a systematic review and meta-analysis

Plastic and Reconstructive Surgery Global Open(2022)

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摘要
PURPOSE: Autologous skin grafts (ASGs) have remained the gold-standard for wound reconstruction for 100+ years but are limited for larger wounds. Cellular tissue-engineered skin constructs (CTSCs) may address these limitations. This novel systematic review and meta-analysis compares outcomes for ASGs, acellular tissue-engineered skin constructs (ATSCs), and CTSCs. METHODS: A systematic review was conducted employ-ing PRISMA guidelines, querying MEDLINE, EMBASE, Web of Science, and Cochrane central to assess graft incor-poration, failure, and wound healing for ASGs, ATSCs, and CTSCs. Case reports/series, reviews, in vitro/in vivo work, non-English articles, or articles without full text were excluded. Articles were screened and data was extracted by four authors independently. RESULTS: 66 articles encompassing 4076 patients were included. From an odds ratio meta-analysis, STSGs trended toward decreased graft failure rates compared to co-grafts of ATSCs with STSGs (p=0.07), while no difference was observed in percent re-epithelialization. Furthermore, improved Vancouver scar scale scores were observed for co-grafts (p=0.09). 20 studies utilized CTSCs, and pooled study results revealed improved re-epithelialization rates of epidermal CTSCs compared to STSGs (20.4% vs. 14% respectively). A lower odds ratio for epidermal CTSC graft failure compared to STSG additionally approached signifi-cance (p=0.05).
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