Hu Nan, Wang Yanni, Galfo Myriam, Qi Hongyan
Department of Burn and Plastic Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Council for Agricultural Research and Economics (CREA), Research Center for Food and Nutrition, Rome, Italy.
Transl Pediatr. 2024 Jul 31;13(7):1210-1218. doi: 10.21037/tp-24-259. Epub 2024 Jul 29.
The efficacy and safety of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) hydrogel in adults with deep partial-thickness burns have been confirmed. However, the clinical safety and efficacy analysis of rhGM-CSF in pediatrics is lacking, and the results are questionable. Therefore, a meta-analysis was conducted to evaluate the efficacy and safety of rhGM-CSF hydrogel in children with second- or third-degree burn injury to provide evidence-based medicine for clinical application.
Articles on rhGM-CSF hydrogel for the treatment of pediatric burn wounds were retrieved from PubMed, Embase, WOS, Cochrane Central Registry of Controlled Trials, Chinese Biomedical Literature Database (CBM), China Science and Technology Journal Database (CSTJ), China National Knowledge Infrastructure (CNKI) and Wanfang from the inception of the databases to March 2024. Two reviewers screened articles and extracted the following data: general characteristics, intervention and treatment course, outcome measure. The meta-analysis was conducted using Revman 5.4 software.
Eight reports (336 patients: experimental 175, control 161) were ultimately included in the meta-analysis, which showed that the experimental group (rhGM-CSF hydrogel ± other therapy) was superior to the control group (treatments without rhGM-CSF hydrogel) in terms of the wound healing rates at day 7 [mean difference (MD) =13.63, 95% confidence interval (CI): 7.25 to 20.00, P<0.001], day 14 (MD =15.59, 95% CI: 12.50 to 18.69, P<0.001), and day 21 (MD =7.47, 95% CI: 7.36 to 7.58, P<0.001), and the wound healing time (MD =-3.10, 95% CI: -3.50 to -2.71, P<0.001), and the differences were statistically significant. For the risks of bias, one study had a "high risk" in allocation sequence concealment, and the others were classified as "low risk" and "unclear risk".
rhGM-CSF hydrogel is significantly effective in improving the wound healing rate and shortening the wound healing time in children with second- or third-degree burns.
重组人粒细胞巨噬细胞集落刺激因子（rhGM-CSF）水凝胶在成人深二度烧伤中的有效性和安全性已得到证实。然而，rhGM-CSF在儿科中的临床安全性和疗效分析尚缺，结果存疑。因此，进行一项荟萃分析以评估rhGM-CSF水凝胶在二度或三度烧伤儿童中的疗效和安全性，为临床应用提供循证医学依据。
从PubMed、Embase、WOS、Cochrane对照试验中心注册库、中国生物医学文献数据库（CBM）、中国科技期刊数据库（CSTJ）、中国知网（CNKI）和万方数据库建库至2024年3月检索关于rhGM-CSF水凝胶治疗小儿烧伤创面的文章。两名 reviewers 筛选文章并提取以下数据：一般特征、干预措施和疗程、结局指标。使用Revman 5.4软件进行荟萃分析。
最终8篇报告（336例患者：试验组175例，对照组161例）纳入荟萃分析，结果显示试验组（rhGM-CSF水凝胶±其他治疗）在第7天（平均差（MD）=13.63，95%置信区间（CI）：7.25至20.00，P<0.001）、第14天（MD =15.59，95% CI：12.50至18.69，P<0.001）和第21天（MD =7.47，95% CI：7.36至7.58，P<0.001）的创面愈合率以及创面愈合时间（MD = -3.10，95% CI：-3.50至-2.71，P<0.001）方面均优于对照组（未使用rhGM-CSF水凝胶的治疗），差异具有统计学意义。关于偏倚风险，一项研究在分配序列隐藏方面为“高风险”，其他研究分类为“低风险”和“不清楚风险”。
rhGM-CSF水凝胶在提高二度或三度烧伤儿童的创面愈合率和缩短创面愈合时间方面具有显著效果。
