Comparative analysis of the autografts and allografts in burn wounds coverage in context of outcomes and rehabilitation perspectives

Burn injuries present significant clinical challenges, necessitating optimal wound coverage strategies to promote healing and functional recovery. This systematic review compares the efficacy of autografts and allografts in burn wound management through analysis of 28 clinical studies (2000-2023). Findings demonstrate autografts superiority as the gold standard for definitive closure, with 85% graft take rates versus 60% for allografts, along with better long-term mobility (30% improvement) and scar outcomes (40% reduced scarring). However, allografts prove indispensable for extensive burns (>40% TBSA), reducing mortality by 15% and ICU costs by $12,000/patient while enabling earlier mobilization. Key rehabilitation data reveal autografts yield superior sensory recovery and quality of life, though allografts facilitate acute-phase stabilization. The analysis identifies patient-specific decision factors including burn size, location and age, with paediatric cases favouring autografts. We conclude that a staged approach—combining initial allograft stabilization with subsequent autografting—optimizes outcomes. Future research should address allograft rejection (15% rate) and autograft donor-site morbidity (25% incidence) through immunomodulation and skin expansion technologies. This synthesis provides evidence-based guidance for burn surgeons to tailor grafting strategies to individual patient needs, balancing survival, function and cost-effectiveness.