Northeastern Society of Plastic Surgeons

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ReCell in Burn Care: A Systematic Review and Meta-Analysis of Clinical Outcomes
Kian Daneshi*1, Jose A. Arellano2, Sarah M. Tepe3, Hilary Liu2, Jenny Ziembicki4, Francesco Egro2
1Imperial College London, Barnet, United Kingdom; 2Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA; 3Department of Surgery, Allegheny Health Network, Pittsburgh, PA; 4Department of Surgery, University of Pittsburgh, Pittsburgh, PA

Background:
ReCell, an autologous cell harvesting technology also known as Autologous Skin Cell Suspension (ASCS), shows potential for accelerating skin regeneration in burn care. However, existing studies vary in methodology and quality, leading to uncertainty regarding its clinical efficacy. This systematic review and meta-analysis evaluates the clinical efficacy of ReCell in burn treatment.

Methods:
A systematic review compliant with PRISMA guidelines was conducted using PubMed, Web of Science, Embase, and Cochrane databases. The protocol was registered on PROPERO (CRD42024606554). The Cochrane Risk of Bias Tool and the Cochrane ROBINS-I tool were used to assess the risk of bias in randomized controlled trials and observational studies, respectively. Methodological quality was evaluated using the GRADE framework.

Results: Fourteen studies (n = 3362) met the inclusion criteria. The pooled mean age of patients was 37.6 years, with a male predominance (n = 2214; 65.9%). The mean TBSA affected was 14.6% (95% CI: 8.8-20.4) under a random-effects model, with significant heterogeneity (I^2 = 95.1%). Meta-analysis demonstrated a reduced complication rate with ReCell combined with split-thickness skin grafting (STSG) compared to STSG alone (RR = 0.64, 95% CI: 0.41-1.00, p = 0.048). However, neither wound infection nor skin graft failure showed significant differences between the ASCS + STSG and STSG alone groups, respectively (RR = 0.78, 95% CI: 0.40-1.51, p = 0.45) (RR = 0.62, 95% CI: 0.31-1.23, p = 0.17).

Conclusions:
ReCell demonstrates potential in reducing complications in burn care, yet the evidence remains inconsistent due to study heterogeneity. Further large-scale, independent randomized controlled trials are necessary to establish ReCell's long-term efficacy, safety, and cost-effectiveness in burn treatment and broader dermatological applications.
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