Outcomes of dermal substitutes in burns and burn scar reconstruction: A systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#humans #burns #cicatrix #plastic-surgery-procedures #re-epithelialization

Outcomes of dermal substitutes in burns and burn scar reconstruction: A systematic review and meta-analysis

van et al., 2024 | Wound Repair Regen | Meta Analysis

Citation

van den Bosch Anna S, Verwilligen Robin A F, ... Middelkoop Esther. Outcomes of dermal substitutes in burns and burn scar reconstruction: A systematic review and meta-analysis. Wound Repair Regen. 2024;32(6):960-978. doi:10.1111/wrr.13226

Abstract

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.

Key Findings

However, future research must prioritise outcome measure uniformity, address variations in dermal substitute application, and standardise indications for consistent and effective practices.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population burns and patients requiring
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Burns
  • Cicatrix
  • Plastic Surgery Procedures
  • Re-Epithelialization
  • Skin Transplantation
  • Skin, Artificial
  • Treatment Outcome
  • Wound Healing

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Systematic Review, Meta-Analysis, Research Support, Non-U.S. Gov't
  • Vertical: collagen

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09