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Advisor(s)
Abstract(s)
Introdução: As queimaduras permanecem um problema de saúde pública global, continuando a representar uma importante causa de morbilidade, estando associadas a longos períodos de hospitalização e a períodos de reabilitação extensos. Acarretam ainda um elevado impacto económico. Têm sido nas últimas décadas desenvolvidos diversos substitutos de pele sintéticos, por forma a criar uma alternativa eficaz aos transplantes de pele comuns.
Objetivos: Explorar os materiais sintéticos disponíveis e comparar a eficácia no tratamento dos doentes queimados dos substitutos de pele sintéticos atualmente disponíveis com os tratamentos convencionais.
Metodologia: Ensaios Clínicos Randomizados ou Ensaios Clínicos Não Randomizados e Estudos observacionais retrospetivos ou prospetivos que respondessem à questão PICO formulada foram identificados através de uma pesquisa na Base de Dados PubMed, tendo sido depois realizada uma revisão sistemática da literatura com base nos mesmos.
Resultados: Quatro ensaios clínicos randomizados foram incluídos na revisão sistemática da literatura realizada. Todos os artigos comparam o enxerto autólogo a um substituto de pele sintético à base de queratinócitos e fibroblastos humanos numa matriz de suporte.
Discussão e Conclusão: Os resultados apontam para uma semelhança entre a utilização dos métodos gold standard e dos novos substitutos de pele sintéticos quer a nível da cicatrização quer a nível da aparência da ferida. No entanto, o baixo número de ensaios clínicos que foquem esta área e a grande variabilidade entre estudos, não permitem garantir qual dos métodos será mais benéfico.
Introduction: Burns remain a global public health issue, representing a major cause of morbidity and being associated to long hospital stays and prolonged rehabilitation periods. Burns are also associated with a big economic burden. Over the last few decades, several skin substitutes have been engineered, providing an effective alternative to common skin grafts. Objectives: To review the synthetic materials currently at hand and to compare the efficiency of the available engineered skin substitutes to the conventional options for the treatment of burn patients. Methods: Randomized clinical trial or nonrandomized clinical trial and retrospective or prospective observational studies which answered the PICO question created were extracted from PubMed. A systematic review was performed. Results: Four Randomized clinical trials were selected for this systematic review. Every study compared autografts to an engineered skin substitute comprised of human keratinocytes and fibroblasts inoculated onto a support substrate. Discussion and Conclusion: Both the gold standard methods and the new engineered skin substitutes seem to have similar results regarding burn healing and appearance. However, due to the small number of studies and the big intrinsic variability between them it is not possible to determine which treatment option is better.
Introduction: Burns remain a global public health issue, representing a major cause of morbidity and being associated to long hospital stays and prolonged rehabilitation periods. Burns are also associated with a big economic burden. Over the last few decades, several skin substitutes have been engineered, providing an effective alternative to common skin grafts. Objectives: To review the synthetic materials currently at hand and to compare the efficiency of the available engineered skin substitutes to the conventional options for the treatment of burn patients. Methods: Randomized clinical trial or nonrandomized clinical trial and retrospective or prospective observational studies which answered the PICO question created were extracted from PubMed. A systematic review was performed. Results: Four Randomized clinical trials were selected for this systematic review. Every study compared autografts to an engineered skin substitute comprised of human keratinocytes and fibroblasts inoculated onto a support substrate. Discussion and Conclusion: Both the gold standard methods and the new engineered skin substitutes seem to have similar results regarding burn healing and appearance. However, due to the small number of studies and the big intrinsic variability between them it is not possible to determine which treatment option is better.
Description
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021
Keywords
Queimaduras Enxerto autólogo Enxerto alogénico Substitutos de pele sintéticos