PLASMA-RICH FIBRIN VERSUS CELLULOSE BIOMEMBRANES FOR BURN WOUND HEALING: A SYSTEMATIC REVIEW AND META-ANALYSIS OF EXPERIMENTAL AND CLINICAL STUDIES

Purpose: To compare autologous plasma‑rich fibrin (PRF) and bacterial or plant‑derived cellulose biomembranes for burn wound healing in experimental and clinical settings. Methods: A systematic review and meta‑analysis was conducted in accordance with PRISMA 2020 and registered in PROSPERO. PubMed, Embase, Scopus, Web of Science and Cochrane Library were searched from 2000 to 31 May 2024. Randomised or controlled clinical studies and controlled animal experiments comparing PRF with cellulose dressings for partial‑ or full‑thickness burns were eligible. Two reviewers independently screened, extracted data and assessed risk of bias. Random‑effects models synthesised mean differences for continuous outcomes and risk ratios for dichotomous outcomes. Results: Seventeen studies met inclusion criteria: 10 controlled animal experiments and seven clinical investigations involving 486 patients. Pooled analysis of clinical trials indicated that PRF reduced time to complete re‑epithelialisation by approximately 3.6 days (95 % CI 2.0–5.2; p < 0.001) compared with cellulose. Pain during dressing changes decreased by about 1.2 cm on a 10‑cm visual analogue scale (95 % CI 0.5–1.9), and infection risk was reduced by 47 % (RR = 0.53; 95 % CI 0.32–0.87). Scar quality scores improved modestly at six months. Heterogeneity ranged from low to moderate across outcomes, and certainty of evidence was rated moderate for re‑epithelialisation and pain. Conclusion: Autologous PRF accelerates epithelial closure, reduces procedural pain and lowers infection rates compared with cellulose biomembranes in burn wounds. These findings support PRF as a promising regenerative dressing, although larger, well‑designed randomised trials with long‑term follow‑up and cost‑effectiveness analyses are needed before widespread implementation.