Discipline of Plastic Surgery, Surgery Department, (UNIFESP/EPM), Brazil.
Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Brazil.
Burns. 2022 Feb;48(1):104-110. doi: 10.1016/j.burns.2021.04.006. Epub 2021 Apr 14.
A burn is a trauma that breaks the skin barrier, causing local and systemic responses. Treatment is complex, multiprofessional and expensive. In addition to surgical treatment, topical dressings can be used to keep the wound moist, reduce the risk of infection and stimulate healing. Clinical studies show that topical use of fibroblast growth factors may accelerate healing. An assessment of the quality of the available evidence and its strength of recommendation is necessary.
This study aimed to evaluate the effectiveness and safety of topical use of fibroblast growth factor, compared to other topical treatments or placebo, in the healing of burns, to determine the strength of recommendation.
Based on a defined search strategy, randomized and quasi-randomized clinical trials, available in electronic databases, were gathered. These compare the topical use of FGF versus other topical or non-treatment. The primary outcome was healing and as adverse effects: pain, infection and mortality. The systematic review protocol was registered on the PROSPERO platform (CRD42018089556), developed in accordance with the "Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) 2015" and within the "SWiM guideline 2019". GRADEpro was used for the critical analysis of the methodology of the studies.
Four clinical trials were found, in which FGF reduced the healing time and improved the appearance of the scar. Two trials were determined to be of low strength, while two others have a moderate recommendation strength.
This review gathered available evidence, between low and moderate recommendation strength for the use of FGF as a topical dressing. Further rigorous trials are needed to improve the strength of recommendation for topical use of FGF for burns.
烧伤是一种破坏皮肤屏障的创伤，会引起局部和全身反应。治疗过程复杂，需要多学科专业人员参与，且费用高昂。除了手术治疗，还可以使用外用敷料来保持伤口湿润，降低感染风险并促进愈合。临床研究表明，局部应用成纤维细胞生长因子可能会加速愈合。因此，有必要评估现有证据的质量及其推荐强度。
本研究旨在评估与其他外用治疗或安慰剂相比，局部应用成纤维细胞生长因子治疗烧伤的有效性和安全性，以确定推荐强度。
根据定义的搜索策略，收集了电子数据库中可用的随机和准随机临床试验，这些试验比较了成纤维细胞生长因子与其他外用药物或非治疗的疗效。主要结局是愈合情况，以及不良反应（疼痛、感染和死亡率）。系统评价方案已在 PROSPERO 平台（CRD42018089556）上注册，该方案符合“系统评价和荟萃分析优先报告项目（PRISMA-P）2015 年”以及“SWiM 指南 2019 年”的要求。使用 GRADEpro 对研究方法进行了批判性分析。
共发现四项临床试验，结果表明成纤维细胞生长因子可缩短愈合时间并改善疤痕外观。其中两项试验被认为强度较低，另外两项则具有中度推荐强度。
本综述汇集了现有证据，为成纤维细胞生长因子作为一种外用敷料的应用提供了低至中度推荐强度。需要进一步开展严格的试验，以提高成纤维细胞生长因子外用治疗烧伤的推荐强度。
