Split-Thickness Skin Graft Versus Conservative Management for Deep Partial-Thickness Burns: A Systematic Review and Meta-Analysis

Superficial burns heal spontaneously, whereas deep burns require grafting. Deep partial thickness (DPT) burns can heal spontaneously but may take longer and can form hypertrophic scars and contractures. The choice between split-thickness skin grafting (STSG) and conservative management for DPT burns remains a dilemma. This systematic review and meta-analysis compares the efficacy and safety of both procedures. PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and ScienceDirect databases were systematically searched for relevant articles. Randomized controlled trials (RCTs), quasi-experimental studies, and cohort studies were included. Case reports, case series, editorials, animal studies, and non-English literature were excluded. The meta-analysis was performed using a random-effects model in RevMan 5.4. Seven studies, including 650 patients, were included in the final analysis. The pooled analysis showed that the STSG group had significantly reduced wound-healing time (standardized mean difference (SMD): -2.01 (-3.80 to -0.22), p=0.03) and a shorter hospital stay (SMD: -3.75 (-6.98 to -0.52), p=0.02). No significant differences were found in wound infection rates, long-term scarring, or the need for reconstructive procedures at a later date. STSG offers a shorter wound-healing time and a reduced hospital stay compared with conservative management for DPT burns. However, due to high heterogeneity and a limited number of studies, further RCTs will help provide better evidence.