Engineered Skin Substitutes in Dermatologic Surgery: A Systematic Review.

IF 2.5 3区医学 Q2 DERMATOLOGY Dermatologic Surgery Pub Date : 2024-08-23 DOI:10.1097/DSS.0000000000004375

Harrison Zhu, Daniel J Lewis, Dylan Haynes, Leo L Wang

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Abstract

Background: Artificial skin substitutes are a flexible alternative to autografting in Mohs micrographic surgery (MMS), but the characteristics and clinical outcomes of skin substitutes are not well defined.

Objective: Summarize clinical data of skin substitutes in MMS for cutaneous malignancy.

Methods: A MEDLINE/Embase/Web of Science search was conducted. Articles with original data on outcomes after skin substitute use in MMS for cutaneous malignancy were included. Articles not in English or without original data were excluded. Bias was assessed using the Oxford CEBM Levels of Evidence Table. Outcomes were synthesized using weighted averages. This study was prospectively registered in PROSPERO.

Results: Of 1,007 articles, 40 met eligibility for inclusion. In total, 898 patients who underwent MMS and received a skin substitute were included. Xenografts were most commonly used ( n = 613). Semi-synthetic grafts (∼$<1/cm 2 ) and xenografts (∼$10/cm 2 ) are most affordable. Overall, outcomes were excellent for all skin substitutes, with a small proportion of patients experiencing correctable complications.

Conclusion: Skin substitutes are highly effective in MMS, with enormous potential. While the data demonstrate positive outcomes, they predominately draw from small, retrospective studies or case reports. There is also a scarcity of data comparing skin substitutes with each other or controls. Prospective studies are recommended.

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皮肤外科手术中的工程皮肤替代物：系统回顾

背景：在莫氏显微外科手术（MMS）中，人工皮肤替代物是自体移植的一种灵活替代方法，但人工皮肤替代物的特征和临床结果尚不十分明确：总结莫氏显微外科手术中皮肤替代物治疗皮肤恶性肿瘤的临床数据：方法：进行MEDLINE/Embase/Web of Science检索。方法：对MEDLINE/Embase/Web Science进行检索，纳入了在皮肤恶性肿瘤MMS中使用皮肤替代物后取得疗效的原始数据的文章。非英文或无原始数据的文章被排除在外。使用牛津 CEBM 证据等级表对偏倚进行评估。结果采用加权平均值进行综合。本研究在 PROSPERO 进行了前瞻性注册：在 1007 篇文章中，有 40 篇符合纳入条件。总共纳入了 898 例接受 MMS 并使用皮肤替代物的患者。最常用的是异种移植（n = 613）。结论：皮肤替代物在 MMS 中非常有效，潜力巨大。虽然数据显示了积极的结果，但它们主要来自小型的回顾性研究或病例报告。将皮肤替代品与其他替代品或对照组进行比较的数据也非常少。建议进行前瞻性研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatologic Surgery 医学-皮肤病学

CiteScore

3.10

自引率

16.70%

发文量

547

期刊介绍： Exclusively devoted to dermatologic surgery, the Dermatologic Surgery journal publishes the most clinically comprehensive and up-to-date information in its field. This unique monthly journal provides today’s most expansive and in-depth coverage of cosmetic and reconstructive skin surgery and skin cancer through peer-reviewed original articles, extensive illustrations, case reports, ongoing features, literature reviews and correspondence. The journal provides information on the latest scientific information for all types of dermatologic surgery including: -Ambulatory phlebectomy- Blepharoplasty- Body contouring- Chemical peels- Cryosurgery- Curettage and desiccation- Dermabrasion- Excision and closure- Flap Surgery- Grafting- Hair restoration surgery- Injectable neuromodulators- Laser surgery- Liposuction- Microdermabrasion- Microlipoinjection- Micropigmentation- Mohs micrographic surgery- Nail surgery- Phlebology- Sclerotherapy- Skin cancer surgery- Skin resurfacing- Soft-tissue fillers. Dermatologists, dermatologic surgeons, plastic surgeons, oculoplastic surgeons and facial plastic surgeons consider this a must-read publication for anyone in the field.