Full thickness skin graft versus split thickness skin graft in paediatric patients with hand burns : systematic review and meta-analysis
Alsaif, Abdulmalik Karam, Mohammad Hayre, Amrit Abul, Ahmad Aldubaikhi, Ahmed Kahlar, Narvair
Alsaif, Abdulmalik
Karam, Mohammad
Hayre, Amrit
Abul, Ahmad
Aldubaikhi, Ahmed
Kahlar, Narvair
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Affiliation
Walsall Healthcare NHS Trust; Farwaniya Hospital; Whittington Health NHS Trust; University of Leeds; King Saud bin Abdulaziz University for Health Sciences; Sandwell and West Birmingham NHS Trust
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Publication date
2022-09-29
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Abstract
Our objective was to compare the outcomes of full thickness skin grafts versus split thickness skin grafts in paediatric hand burn patients. A systematic review and meta-analysis were carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines, and an electronic search was conducted to identify all Randomised Controlled Trials and non-randomised studies comparing the outcomes of full thickness skin grafts versus split thickness skin grafts in paediatric hand burn patients. Primary outcomes included development of post-graft contracture and the necessity for surgical release. Secondary outcomes consisted of evaluation of function, cosmesis and colour, scar and feeling, hair growth, and other complaints. For the analysis, fixed effects modelling was applied. Results: ten non-randomised trials with a total of 532 grafts were found. Full thickness skin grafts exhibited a statistically significant decrease in the development of post-graft contracture (Odds Ratio [OR] = 0.35, P = 0.0001) and later surgical releases (OR = 0.06, P = 0.00001). For secondary outcomes, full thickness skin grafts outperformed split thickness skin grafts in post-operative functional ability. However, split thickness skin grafts, showed to be superior in scar, aesthetic, and colour assessments, and less hair growth was observed for split thickness skin grafts. No significant difference was seen in sensation and donor or recipient site complaints. Overall, full thickness skin grafts are a better alternative for paediatric hand burns than split thickness skin transplants because they are linked with reduced post-graft contracture and the requirement for surgical release.
Citation
Alsaif A, Karam M, Hayre A, Abul A, Aldubaikhi A, Kahlar N. Full thickness skin graft versus split thickness skin graft in paediatric patients with hand burns: Systematic review and meta-analysis. Burns. 2023 Aug;49(5):1017-1027.
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Article