Cuidados de las zonas donantes de injertos de piel de espesor parcial. Umbrella review

Abstract

ObjectivesTo summarize the current evidence and develop recommendations on the most effective management of partial-thickness graft donor sites in adults to improve re-epithelialization, pain, and infection. MethodologyUmbrella review. A systematic search of Pubmed, CUIDEN, Cochrane Library, CINHAL Plus, SCOPUS, and LILACS databases was conducted between October and December 2021, including systematic reviews published in the last 10 years that inquired about the effectiveness of any partial-thickness graft donor site healing strategy. Reviews with very low critical appraisal according to AMSTAR 2 were excluded. Included reviews were scored using the SIGN scale to determine their level of evidence and grade of recommendation. ResultsFive systematic reviews with meta-analysis were included. A statistically significant improvement in re-epithelialization and pain was observed in platelet-rich plasma and human amniotic membrane in relation to the control group. In addition, wound infection also decreased in platelet-rich plasma. A decrease in re-epithelialization time was also observed in recombinant human growth hormone. ConclusionsThe use of platelet-rich plasma is recommended to improve re-epithelialization, pain, and infection in partial-thickness graft donor sites in adults. The application of human amniotic membrane is recommended to accelerate re-epithelialization and reduce pain, and recombinant human growth hormone is recommended to accelerate the time to completely heal these wounds.