Dr Anjana Bairagi1, Dr Bronwyn Griffin1,2,3, Prof Steven McPhail4,5, Prof Roy Kimble1,2,3,6, Dr Zephanie Tyack1,4,5
1Centre for Children’s Burns & Trauma Research, Brisbane,, Australia, 2Pegg Leditschke Children’s Burns Centre, Queensland Children’s Hospital, Brisbane,, Australia, 3School of Nursing & Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane,, Australia, 4School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane,, Australia, 5Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia, 6Faculty of Medicine, University of Queensland, Brisbane,, Australia
Acute partial thickness burns are commonly of mixed depth and continue to be a challenge to manage due to the potential for unacceptable scar outcomes. In the past four decades, autologous skin cell suspensions (ASCS) have progressed remarkably from simple origins of serial keratinocyte cultures to a variety of formulations available today. The objective of this systematic review was to evaluate the effectiveness and type of ASCS used in the management of partial thickness burn injuries.
In April 2019, EMBASE, Google Scholar, MEDLINE, Web of Science, grey literature and relevant journals were searched. The inclusion criteria for eligible studies (n=2851) were randomised controlled trials (RCT) and pilot RCT of human partial thickness burns and donor sites managed with non-cultured ASCS. Two independent researchers used Covidence® for screening, quality assessment and data extraction. The Cochrane Risk of Bias and Grading of Recommendations Assessment, Development, and Evaluation tools were used for risk of bias assessment.
Five included studies, conducted in Australia, China, Italy, Switzerland and USA, had mostly adult participants (n=4 studies). ASCS was prepared with RECELL® autologous cell harvesting device (n=4 studies) and a laboratory method (n=1 study). ASCS has been reported as effective to reduce wound re-epithelialisation time (n=4 studies), improve scar quality (n=2 studies), as well as reduce donor site area (n=2 studies) and pain (n=3 studies).
ASCS have been used predominantly in adult populations. The dearth of studies regarding the management of paediatric partial thickness injuries with ASCS justifies further research in this population.
Dr Anjana Bairagi is a paediatric surgeon undertaking a PhD with the Centre of Children’s Burns & Trauma Research Group. Her research is evaluating non-cultured autologous skin cell suspensions in the management of partial thickness burn injuries in children.