Promoting wound healing in burnt patients : autografts vs allografts

Abstract

Overview of the topic: Burn injuries are responsible for 180,000 deaths globally each year from fires alone (Stevenson et al,2020). However, the survivors need to be treated with immediate effect to reduce scar appearance and any additional trauma to tissue, nerves and organs. Healing burn wounds is complex and when a vast area of the body is affected, skin grafting may be considered. Autografts is skin used from the same individual and allografts is skin used from donors after their death also known as cadaver skin. This dissertation will present the effectiveness of healing in these grafts on burn wounds. The Research Question: Amongst burned patients, how does autograft as opposed to allograft affect the healing process? The Pico Elements: The population studied was on burned patients, the intervention was on autografts while the comparison was on allografts. The outcome was how these grafts affected wound healing. Methods: Ebsco Host, PubMed, BioMed, ProQuest and Hydi were databases used to find the best data available. However, the Science Direct database was the one with most of the chosen studies. Manual searching through the references lists was also conducted. The PRISMA checklist was used to filter irrelevant articles. Search tools and keywords were used to increase the number of hits to discover a wider range of relevant studies. The inclusion and exclusion criteria were applied to determine the limits of the studies. The CASP tool was also used to critically appraise the chosen studies. Results: Two systematic reviews one including a Meta-analysis, One Randomised Controlled Trial and Three Cohort studies were selected as the main studies, six in total. The chosen studies were found to be inconsistent as they had different opinions about which graft was most effective. Therefore, as a conclusion the research question could not be answered. The differences in the methodological quality and the limitations might be the answer of the discrepancy of the findings. Recommendations: Follow-up appointments and a larger sample size were the main recommendations to provide a better outcome for future research. Additionally, by encouraging the public to donate their skin after their death helps increase the possibility of enlarging the field of skin graft usage in Malta and also helps provides local studies on the subject.