Análise do uso de aloenxerto de pele e membrana amniótica em queimaduras: revisão sistemática

Abstract

Introduction: Burns are among the main traumas in the world and their treatment is highly complex. Objectives: Thus, this study was aimed to identify the effectiveness of skin and amniotic membrane allograft coverage techniques in 2nd and 3rd degree burns. Methodology: In June 2020, systematic searches were performed in three electronic databases (Lilacs, Scielo and Pubmed) and manual searches in the reference lists of the articles assessed. The following inclusion criteria was defined: samples composed of patients with 2nd and 3rd degree burns; who use skin and/or amniotic membrane allograft as treatment, analyzing hospital stay, healing time, infection rate, mortality, treatment cost, number of dressing changes, pain, material availability or rejection. Regarding study design, observational (cohort, case-control) and experimental (randomized clinical trials) studies were included, reported in Portuguese, English or Spanish. Outcomes such as length of stay, healing and infection rate were assessed. Results: From 497 initial studies, 17 studies composed the descriptive synthesis. Nine of them analyzed the use of skin allograft, seven the use of amniotic membrane and one analyzed both covering techniques. The average length of stay ranged from 8.5 to 91.6 days with skin allograft and from 10.9 to 25 days with amniotic membrane. Mean healing time ranged from 14 to 19 days with skin allograft and from 5.4 to 17.5 days with amniotic membrane. The infection rate ranged from 5.9 to 20% with skin allograft and from 0 to 4.3% with amniotic membrane. Conclusion: It is concluded that in burned body surface and greater depth, there seems to be a tendency to use skin allograft. The potential for suppression of infections with the use of an amniotic membrane is perceived. Further studies using amniotic membrane in extensive burns, comparing with the use of skin allograft, and analyzing the infection rate are suggested.