Autologous Skin Cell Suspension in Burn Care: A Systematic Review and Meta-analysis of Clinical Outcomes

ReCell, is a skin processing device that produces an autologous skin cell suspension (ASCS), which has shown promise in enhancing skin regeneration for patients with burn injuries. Despite its growing use in clinical practice, the current literature displays considerable variability in study design and quality, leading to ongoing uncertainty about its true clinical effectiveness. This systematic review and meta-analysis aims to comprehensively evaluate the clinical efficacy of ReCell's ASCS technology in the treatment of burns. A systematic review was conducted in accordance with PRISMA guidelines, using searches across PubMed, Web of Science, Embase, and Cochrane databases. The review protocol was prospectively registered on PROSPERO (CRD42024606554). The Cochrane Risk of Bias Tool and the ROBINS-I tool were applied to assess bias in randomized controlled trials and observational studies, respectively. The overall methodological quality of included studies was appraised using the GRADE framework. Fourteen studies (n = 3362) fulfilled the inclusion criteria. The pooled mean patient age was 38.35 years, with a male predominance (69.8%). The average %TBSA affected was 14.6% (95% CI: 8.76-20.44), with substantial heterogeneity (I2 = 95.1%). Meta-analysis demonstrated a statistically significant reduction in complication rates with ASCS combined with split-thickness skin grafting (STSG) compared to STSG alone (RR = 0.64, 95% CI: 0.41-1.00, P = .048). However, rates of wound infection and graft failure did not differ significantly between groups. ASCS demonstrates potential to reduce complications in burn care. Nevertheless, due to heterogeneous study designs, further high-quality, large-scale randomized trials are warranted to validate its long-term efficacy and broader clinical utility.