自体脂肪移植和脂肪来源干细胞疗法治疗急性烧伤及烧伤相关瘢痕:一项系统综述。
Autologous fat grafting and adipose-derived stem cells therapy for acute burns and burn-related scar: A systematic review.
作者信息
Lesmanawati Fanny Evasari, Windura Carolus Aldo, Saputro Iswinarno Doso, Hariani Lynda
机构信息
Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia.
出版信息
Tzu Chi Med J. 2024 Mar 6;36(2):203-211. doi: 10.4103/tcmj.tcmj_189_23. eCollection 2024 Apr-Jun.
OBJECTIVES
The objective of this study was to analyze all available research on the application of autologous fat grafting (AFG) and adipose-derived stem cells (ADSC) to present evidence-based recommendations, particularly in the clinical treatment of acute burns and burn-related scars.
MATERIALS AND METHODS
We conducted a systematic search of PubMed, COCHRANE, and EMBASE, as well as a manual search of previous reviews' reference lists up. The risk of bias (RoB) was assessed using RoB 2.0 and ROBINS-I, where appropriate.
RESULTS
Six eligible studies were selected (2 randomized clinical trials [RCT], 1 retrospective cohort, and 3 experimental studies) with subjects ranging from 3 to 100. Only one study evaluated the use of AFG for acute burns. Improvements in wound healing, vascularization, scar characteristics, and tissue architecture were generally observed in some studies, supported by molecular markers, while one study reported nonsignificant results. Subjective patient satisfaction was reported to have improved. Functional outcomes improvement in the treated regions was minimal. However, study heterogeneity arose mainly from treatment protocols. Cautious results interpretation due to potential bias, especially in selection and confounding domains, and limited clinical trials are important to note. More studies are needed to evaluate.
CONCLUSION
AFG and ADSC hold potential as valuable treatment options for burn-related scars, supported by a body of evidence, but further well-designed RCT are needed. The efficacy of acute burn settings is yet to be further evaluated since evidence is limited.
目的
本研究的目的是分析所有关于自体脂肪移植(AFG)和脂肪来源干细胞(ADSC)应用的现有研究,以提出基于证据的建议,特别是在急性烧伤和烧伤相关瘢痕的临床治疗中。
材料与方法
我们对PubMed、COCHRANE和EMBASE进行了系统检索,并手动检索了以往综述的参考文献列表。在适当的情况下,使用RoB 2.0和ROBINS-I评估偏倚风险(RoB)。
结果
选择了六项符合条件的研究(2项随机临床试验[RCT]、1项回顾性队列研究和3项实验研究),受试者人数从3人到100人不等。只有一项研究评估了AFG用于急性烧伤的情况。在一些研究中,通常观察到伤口愈合、血管生成、瘢痕特征和组织结构有所改善,有分子标记物支持,而一项研究报告结果无统计学意义。据报道,患者主观满意度有所提高。治疗区域的功能结果改善最小。然而,研究异质性主要源于治疗方案。由于潜在偏倚,尤其是在选择和混杂领域,需要谨慎解释结果,并且有限的临床试验也值得注意。需要更多研究进行评估。
结论
AFG和ADSC作为烧伤相关瘢痕的有价值治疗选择具有潜力,有一定证据支持,但需要进一步设计良好的RCT。由于证据有限,急性烧伤情况下的疗效尚待进一步评估。
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