Comparative efficacy of decellularized biological matrices for the treatment of adults with deep or chronic skin wounds: A systematic review of randomized clinical trials
Galvis Escobar, Sara Maria
López Rendón, Alejandra
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AbstractBackground: Chronic and deep skin wound are a global public health problem. Novel treatments like decellularized biological matrices have many advantages compared to standard and traditional treatments. Objective: This systematic review evaluates the efficacy of the treatment of adults with deep or chronic skin wounds with decellularized biological matrices compared to other types of dressings and treatments, in randomized clinical trials, using scientific evidence from the literature. As a secondary outcome, safety of these matrices is studied as well. Methods: Two researchers searched Scopus, PubMed, EBSCO, MEDLINE, LILACS, the Cochrane Central Register of Controlled Trials, the registry ClinicalTrials.gov, and the repository medRxiv for relevant titles, with no timeframe. Inclusion criteria included studies that were randomized controlled ones investigating the effects decellularized biological matrices compared to any other type of treatment on chronic or deep skin wounds. Data was extracted by the two authors independently, and risk of bias was analyzed. A qualitative synthesis was performed. Results: Data from 13 studies was included. 7 of these studies were analyzed for their results, after risk of bias evaluation. The results from these studies included in the synthesis show that decellularized biological matrices are more efficacious in healing adult patients, with no evidence of more or less adverse events, compared to other treatments. However, this trend is not robust, shown in the wide prediction intervals obtained. Conclusions: This study shows decellularized biological matrices seem to have a higher rate of healing and no difference in occurrence of adverse events, when compared with other treatments. However, evidence is scarce and the conclusion is weak, due to low certainty of the available evidence, highlighting the importance of updating this review with new evidence.