Abstract
BackgroundAutologous skin grafting is an important modality for wound coverage; however, it can result in donor site morbidity. Epidermal grafting is an emerging option to overcome this challenge. Furthermore, it can be done in an outpatient setting with minimal or no pain. To date, the evidence on the efficacy of this technique for wound healing has yet to be outlined. We aim to synthesise the current evidence on epidermal grafting for wound healing to establish the efficacy of this technique.Methods/designWe will conduct a comprehensive search in the MEDLINE, EMBASE, and CENTRAL databases (up to May 2016) to identify studies on epidermal grafting for wound healing. We will include any primary studies (excluding case reports or case series lesser than three patients) or systematic reviews of such studies to assess the outcome of epidermal grafting for wound healing either on its own or compared to other methods. The expected primary outcome measures are the efficacy of epidermal grafting for wound healing (measured by the proportion of wounds healed at 6 weeks) and the mean wound-healing time (time for complete re-epithelialisation). Secondary outcome measures are the mean donor site-healing time, need for anaesthesia, costs associated with resource use, health-related quality of life, and proportion of patients with adverse event. Subgroup analysis will be performed for the proportions of wounds healed based on wound aetiology.DiscussionThis is a timely systematic review, and the finding of this systematic review is expected to guide research and clinical practice aimed at improving wound care.Systematic review registrationPROSPERO CRD42016033051Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0268-7) contains supplementary material, which is available to authorized users.
Highlights
Autologous skin grafting is an important modality for wound coverage [1]
The search strategy will use a combination of text word and Medical Subject Headings (MeSH) terms relating to the use of epidermal graft in treating wounds
In this review, we aim to determine the efficacy of epidermal grafting for wound healing by evaluating the overall success rate of this technique for wound healing and the mean wound and donor site-healing time which is currently unclear
Summary
Autologous skin grafting is an important modality for wound coverage [1]. It can be classified based on the thickness of the harvested skin, namely, full-thickness skin graft (FTSG), split-thickness skin graft (SSG), and epidermal graft (EG) [2, 3].FTSG consists of the epidermis and the entire dermis of the skin. SSG involves the excision of the epidermis and part of the dermis, using an electric air dermatome, leaving behind the reticular dermis in the donor site enabling the skin to heal by secondary intention [1]. It is the commonest form of autologous skin grafting performed and can be meshed to cover a wide surface area [1]. The donor site becomes a second, often painful wound, which may take more time to heal than the graft site itself and holds the risk of infection and scarring [4] Both the FTSG and SSG often require hospital admission, even as a day case, anaesthesia, and a period of immobility for some patients. We aim to synthesise the current evidence on epidermal grafting for wound healing to establish the efficacy of this technique
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