The early management of
burn cases has always been a challenging medical problem.
Skin substitutes have been consistently studied and employed as the prospective treatment modality for
burn cases worldwide. However, this treatment method remains uncommon in many developing countries. This systematic review is designed to weigh the efficacy of
skin substitutes compared to standard treatment for managing acute
burn cases. A literature search was conducted using PubMed, Scopus and Cochrane database up to February 2020 combined with additional reference searching. Studies were restricted to randomized controlled trials (RCTs), with no date and language restrictions. We evaluated the risk of bias with a revised risk of bias tool for randomized trials (RoB2). Data were categorized based on
skin substitutes with further subgroup analysis for each
skin substitute. We included 13 studies with six types of
skin substitutes, Biobrane®,
TransCyte ®, Integra®, Glyaderm®, Suprathel® and Apligraft®. Outcomes measured included wound healing time,
pain, length of hospitalization and
scar formation. The findings for all
skin substitutes demonstrated less severe
pain compared to the control group. Faster wound healing time,
scar formation and length of hospitalization were identified as heterogeneous depending on the type of
skin substitutes used. All of the
skin substitutes studied exhibited at least non-inferior to superior performance compared to standard treatment in terms of efficacy in treating acute
burn wounds, not limited to
burn depth, size, location or patient age.