Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Universitas Airlangga, Indonesia
Jl. Mayjend Prof. Dr. Moestopo, No. 6-8, Surabaya, 60285.
🔥 Does Timing Matter in Burn Wound Grafting? Evidence from a Meta-Analysis
Burn injuries remain a major global health burden, with more than 265 million cases annually worldwide. Surgical skin grafting is a cornerstone in burn management, yet the optimal timing of grafting, whether early or delayed continues to be debated, especially in settings with limited resources.
This systematic review and meta-analysis published in Jurnal Rekonstruksi dan Estetik (JRE) evaluates the clinical and functional outcomes of early versus delayed wound grafting in burn patients.
📄 Article Title: Comparative Outcomes of Early Versus Delayed Wound Grafting in Burn Patients: A Systematic Review and Meta-Analysis 🔗 DOI: https://doi.org/10.20473/jre.v10i2.75022
📌 Why This Study Matters
Early excision and grafting,traditionally performed within 48 hours to 7 daysis believed to:
Reduce infection risk
Shorten hospital stay
Improve functional recovery
Lower morbidity and mortality
However, factors such as hemodynamic instability, inadequate resuscitation, and limited surgical resources often delay intervention, particularly in low- and middle-income countries. This study provides evidence-based guidance to support clinical decision-making.
🔍 Methods at a Glance
Study design: Systematic review and meta-analysis
Search period: July 2024 – January 2025
Study types included:
Randomized controlled trials
Cohort studies
Observational studies
Comparison groups:
Early grafting (within 3–7 days)
Delayed grafting (after 7 days)
Outcomes assessed:
Length of hospital stay
Infection rates
Blood loss
Limb and hand function (TAM & grip strength)
📊 Key Results
250 studies identified, 7 studies met inclusion criteria
Hospital stay:
Early grafting significantly reduced hospitalization by 8.89 days (95% CI: −12.88 to −4.89)
Functional outcomes:
Early grafting showed significantly better Total Active Movement (TAM) MD: 22.10(95% CI: 17.95 to 26.24)
Other outcomes:
No statistically significant differences between early and delayed grafting in:
Blood loss
Infection rates
Post-operative grip strength
🧠 Clinical Interpretation
✅ Early wound grafting offers clear benefits in:
Faster recovery
Shorter hospital stay
Improved postoperative limb mobility
⚠️ However, early grafting did not significantly outperform delayed grafting in terms of infection rates or blood loss, highlighting the importance of patient condition and surgical readiness rather than timing alone.
🎯 Key Takeaways
Early grafting improves functional recovery and hospitalization outcomes
Timing should be balanced with patient stability and resource availability
Supports early intervention when clinically feasible
Calls for further high-quality studies to refine timing protocols
📚 Published in: Jurnal Rekonstruksi dan Estetik ✍️ Authors: Rafeni Bunga, Beta Subakti Nata’admaja 🏥 Affiliations:
✨ Exploring Snail Mucus as a Novel Bioactive Agent in Wound Repair
Wound healing is a complex biological process that requires a coordinated interaction between inflammation control, collagen synthesis, angiogenesis, and tissue remodeling. Despite advances in wound care, delayed healing remains a significant clinical challenge prompting ongoing exploration of natural bioactive substances that can support tissue regeneration.
A recent article published in Jurnal Rekonstruksi dan Estetik systematically evaluates the therapeutic potential of snail mucus extract as a wound-healing agent through a systematic review and meta-analysis of randomized controlled trials (RCTs).
Proteins play a pivotal role in wound repair, mediating cellular migration, extracellular matrix formation, and tissue remodeling. Snail mucins, large glycosylated proteins found in snail mucus, have been reported to:
Stabilize protein structures
Enhance cell–cell recognition
Modulate viscosity and solubility
Promote collagen production
Reduce inflammatory responses
This study provides a rigorous evidence-based evaluation of these proposed benefits.
🔍 Key Findings from the Meta-Analysis
🔹 Study Design and Methodology
Meta-analysis of randomized controlled trials
Databases searched:
PubMed
ProQuest
Web of Science
ScienceDirect
Scopus
EBSCOHost
ClinicalTrials.gov
Methodological framework:
PRISMA guidelines
PICO framework
Quality assessment using the JADAD scale
🔹 Quantitative Results
3 RCTs (2021–2023)
Total of 60 animal subjects (rats)
Snail mucus group showed a significantly faster wound healing rate compared to controls:
Mean Difference (MD): −3.21%
95% CI: −3.72 to −2.69%
P < 0.00001
These results indicate a robust and statistically significant effect.
🧬 Biological Mechanisms Behind Snail Mucus
The bioactive components of snail mucus contribute to wound healing by:
Enhancing collagen synthesis
Reducing local inflammation
Supporting cellular proliferation and migration
Improving tissue remodeling dynamics
These mechanisms align well with modern principles of regenerative medicine and biomaterial-based wound therapy.
⚠️ Translational Considerations
While the findings strongly support the wound-healing efficacy of snail mucus in animal models, the authors emphasize the need for:
Well-designed clinical trials
Standardized formulations
Safety and dosage evaluations in humans
🎯 Why This Article Is Worth Reading and Citing
Provides pooled quantitative evidence via meta-analysis
Highlights snail mucus as a promising natural wound-healing agent
Integrates molecular rationale with experimental outcomes
Relevant to plastic surgeons, wound care specialists, and regenerative medicine researchers
Opens avenues for future translational and clinical research
📚 Published in: Jurnal Rekonstruksi dan Estetik ✍️ Authors: Febe Alodia Widjaja et al. 🏥 Affiliations: Universitas Airlangga, Universitas Airlangga Hospital, Dr. Soetomo General Academic Hospital, University of Twente
✨ Reassessing Routine Antibiotic Use in Maxillofacial Trauma Surgery
Maxillofacial trauma surgery frequently involves contaminated wounds, complex anatomy, and prolonged operative time, factors traditionally associated with a higher risk of surgical site infections (SSIs). For this reason, antibiotic prophylaxis has long been prescribed as routine practice. However, growing concerns regarding antimicrobial resistance, unnecessary costs, and unclear clinical benefit have prompted critical re-evaluation of this approach.
A recent systematic review published in Jurnal Rekonstruksi dan Estetik addresses this ongoing debate by examining whether prophylactic antibiotics truly reduce SSI rates in maxillofacial trauma surgery.
Despite widespread use, recommendations on whether, when, and how long antibiotics should be given in maxillofacial trauma surgery remain inconsistent. Overprescription not only increases healthcare costs but also contributes to the global threat of antimicrobial resistance.
This systematic review provides an evidence-based assessment to support more rational, patient-centered antibiotic use.
🔍 Key Findings from the Review
🔹 Study Design and Methodology
Systematic search conducted using Google Scholar
Selection based on PICO framework
Included observational cohort studies
Study quality assessed using the JBI Critical Appraisal Checklist for Cohort Studies
A total of six studies met the inclusion criteria.
🔹 Do Prophylactic Antibiotics Reduce SSIs?
Five of six studies found no significant reduction in SSI rates with prophylactic antibiotics
Lack of benefit observed regardless of:
Timing (preoperative vs postoperative)
Duration of antibiotic administration
Only one study reported a statistically significant reduction in SSIs with preoperative prophylaxis
Variations in surgical technique, antibiotic regimens, patient characteristics, and study design likely contributed to inconsistent findings.
🔹 Postoperative Antibiotics: More Harm Than Benefit?
The review highlights that postoperative antibiotic regimens:
Do not reduce SSI rates
Increase treatment costs
Contribute to antimicrobial resistance
These findings challenge the routine use of prolonged antibiotics after maxillofacial trauma surgery.
⚠️ Clinical Implications
Rather than universal prophylaxis, the evidence supports a selective, risk-based approach, reserving antibiotics for:
Immunocompromised patients
Grossly contaminated wounds
Extensive soft-tissue injury
Prolonged or complex surgical procedures
Such an approach aligns with modern principles of antibiotic stewardship and evidence-based surgical care.
🎯 Why This Article Is Worth Reading and Citing
Clarifies controversies surrounding antibiotic prophylaxis in maxillofacial trauma
Supports judicious and selective antibiotic use
Reinforces antimicrobial stewardship principles
Relevant for oral and maxillofacial surgeons, plastic surgeons, and trauma teams
Highlights the need for high-quality randomized controlled trials
📚 Published in: Jurnal Rekonstruksi dan Estetik ✍️ Authors: Naufal Agus Isamahendra, Muhammad Tidar Abiyyu, Iswinarno Doso Saputro, Yanuar Ari Pratama 🏥 Institution: Faculty of Medicine, Universitas Airlangga & Dr. Soetomo General Academic Hospital
✨ Revisiting Topical Burn Care: Is MEBO a Better Alternative to Silver Sulfadiazine?
Burn injuries remain a significant global health challenge, often requiring prolonged wound care and posing risks of infection, delayed healing, scarring, and surgical intervention. For decades, silver sulfadiazine (SSD) has been widely used as the standard topical therapy for partial-thickness burns. However, growing concerns regarding delayed epithelialization and potential adverse effects have prompted clinicians to explore alternative treatments.
One such alternative is Moist Exposed Burn Ointment (MEBO), a plant-based topical agent originating from traditional Chinese medicine. But how does MEBO truly compare to SSD in terms of clinical effectiveness?
A recent systematic review published in Jurnal Rekonstruksi dan Estetik provides evidence-based answers to this question.
📄 Article Title: Wound Healing Efficacy of Moist Exposed Burn Ointment (MEBO) and Silver Sulfadiazine in Partial-Thickness Burns: A Systematic Review 🔗 DOI: https://doi.org/10.20473/jre.v10i2.71980
📌 Why This Study Is Important
Topical agents play a crucial role in burn wound management, influencing healing time, infection rates, pain control, and the need for surgical intervention. Despite SSD’s long-standing use, its drawbacks have fueled interest in alternatives that promote faster and more physiological wound healing.
This systematic review synthesizes existing clinical evidence comparing MEBO and SSD, offering clinicians clearer guidance when choosing topical therapy for partial-thickness burns.
🔍 Key Insights from the Systematic Review
🔹 What Is MEBO?
MEBO is a herbal-based topical ointment containing:
Sesame oil – moisture retention and barrier protection
Beta-sitosterol – anti-inflammatory effects
Berberine – antimicrobial properties
Together, these components create an optimal moist wound environment that supports natural epithelial regeneration.
🔹 Evidence from Clinical Trials
Five clinical trials (2000–2008) were included
Databases searched: PubMed, Cochrane, and ScienceDirect
Keywords: MEBO, SSD, burns, wound healing
Across all included studies, MEBO demonstrated comparable or superior outcomes when compared with SSD.
🔹 Improved Wound Healing Outcomes with MEBO
Consistent findings showed that MEBO was associated with:
Potentially reduces healthcare burden by minimizing surgical needs
🎯 Clinical Implications
The findings suggest that MEBO is not only an effective alternative but may be a preferable option for managing partial-thickness burn wounds, particularly in settings where optimizing healing time and patient comfort is a priority.
For burn units, plastic surgeons, and wound care specialists, this review supports the integration of MEBO into evidence-based burn management protocols.
📚 Why This Article Is Worth Reading and Citing
Systematic comparison of MEBO and SSD in burn care
Highlights advantages of plant-based topical therapy
Reinforces modern moist wound healing concepts
Useful for clinicians, burn specialists, and researchers
Supports informed clinical decision-making
📚 Published in: Jurnal Rekonstruksi dan Estetik ✍️ Authors: Aditya Wardhana, Nadya Farhana 🏥 Institution: Burn Unit, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia
