Polylactic Acid Skin Substitute in Pediatric Burn Management: A Systematic Literature Review and Meta-Analysis

Pediatric burn injuries remain a leading cause of global morbidity, with complications such as delayed healing, infection, and hypertrophic scarring contributing to long-term functional and psychosocial burden. Polylactic acid skin substitutes have gained traction as a synthetic dressing option in pediatric burn care, yet outcome variability across studies necessitates a formal synthesis. Our objective was to evaluate the efficacy of polylactic acid skin substitutes in pediatric burn management by assessing healing time, infection rates, hypertrophic scarring, and pain scores through a systematic review and meta-analysis. A systematic search of PubMed, Scopus, and Embase identified studies reporting outcomes of pediatric burn patients treated with polylactic acid membranes. Nine studies (n = 811 pediatric patients) met inclusion criteria. Meta-analyses were conducted for healing time, infection rate, and hypertrophic scarring. Four additional studies were analyzed qualitatively due to heterogeneity in outcome reporting or study design. The pooled weighted mean healing time across 3 studies was 14.0 days (95% CI, 9.7-18.4), with moderate heterogeneity (I2 = 48.9%). The pooled infection rate across 4 studies was 5% (95% CI, 0%-66%), and the pooled hypertrophic scarring rate from 2 studies was 12% (95% CI, 1%-73%). Narrative synthesis revealed additional benefits, including systemic antioxidant effects, though challenges such as premature detachment were noted. In conclusion, polylactic acid skin substitutes demonstrate favorable performance in pediatric burn management, promoting timely reepithelialization, reducing infection, and mitigating scarring risk. While overall findings support its utility, variability in outcome definitions and moderate heterogeneity highlight the need for standardized protocols.