Autologous Skin Cell Suspension (ASCS) in Pediatric Burn Injuries: A Systematic Review and Meta-analysis

Autologous skin cell suspension (ASCS) technology has emerged as a promising advancement in pediatric burn care, offering potential benefits in wound healing, aesthetic outcomes, and resource utilization. This systematic review and meta-analysis evaluated 8 studies encompassing 135 pediatric patients with burns ranging from 0.3% to 90% total body surface area (TBSA). Autologous skin cell suspension demonstrated significant efficacy in promoting rapid reepithelialization, with mean times to > 90% reepithelialization ranging from 7 to 81 days. A sensitivity analysis excluding high-TBSA outliers confirmed improved precision in pooled healing time (13.2 days, 95% CI: 0.2-26.2), suggesting ASCS may be particularly effective in moderate burns. Aesthetic outcomes were favorable, particularly in facial burns, where ASCS minimized visible scarring and reduced complications. Resource utilization findings highlighted reduced hospital length of stay (LOS) by 2.9 days for small burns and a 60% reduction in autograft needs in full-thickness burns. However, substantial heterogeneity was noted in healing and LOS outcomes, as evidenced by high I2 values in meta-analyses, indicating variability in study populations and protocols. Limitations included small sample sizes, single-center designs, and variability in follow-up durations. Despite these challenges, ASCS shows promise in pediatric burn care, emphasizing the need for standardized protocols and further research to optimize its application. These findings suggest that ASCS could enhance both clinical outcomes and patient quality of life, making it a valuable addition to pediatric burn management strategies.