title: Protocol for a systematic review of the efficacy of epidermal grafting for wound healing.
abstract: BACKGROUND
  Autologous skin grafting is an important modality for wound coverage; however, it can result in donor site morbidity. Epidermal grafting is an emerging option to overcome this challenge. Furthermore, it can be done in an outpatient setting with minimal or no pain. To date, the evidence on the efficacy of this technique for wound healing has yet to be outlined. We aim to synthesise the current evidence on epidermal grafting for wound healing to establish the efficacy of this technique.
  
  
  METHODS
  We will conduct a comprehensive search in the MEDLINE, EMBASE, and CENTRAL databases (up to May 2016) to identify studies on epidermal grafting for wound healing. We will include any primary studies (excluding case reports or case series lesser than three patients) or systematic reviews of such studies to assess the outcome of epidermal grafting for wound healing either on its own or compared to other methods. The expected primary outcome measures are the efficacy of epidermal grafting for wound healing (measured by the proportion of wounds healed at 6 weeks) and the mean wound-healing time (time for complete re-epithelialisation). Secondary outcome measures are the mean donor site-healing time, need for anaesthesia, costs associated with resource use, health-related quality of life, and proportion of patients with adverse event. Subgroup analysis will be performed for the proportions of wounds healed based on wound aetiology.
  
  
  CONCLUSIONS
  This is a timely systematic review, and the finding of this systematic review is expected to guide research and clinical practice aimed at improving wound care.
  
  
  BACKGROUND
  PROSPERO CRD42016033051.
authors.affiliation: Division of Surgery and Interventional Science, University College London, London, UK. muholan.kanapathy.13@ucl.ac.uk.|Royal Free Hospital Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK. muholan.kanapathy.13@ucl.ac.uk.
authors.forename: Muholan
authors.initials: M
authors.lastname: Kanapathy
authors.affiliation: Royal Free Hospital Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Smith
authors.affiliation: Royal Free Hospital Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.
authors.forename: Nadine
authors.initials: N
authors.lastname: Hachach-Haram
authors.affiliation: Royal Free Hospital Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Bystrzonowski
authors.affiliation: Division of Surgery and Interventional Science, University College London, London, UK.|Royal Free Hospital Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.
authors.forename: Afshin
authors.initials: A
authors.lastname: Mosahebi
authors.affiliation: Division of Surgery and Interventional Science, University College London, London, UK.|Royal Free Hospital Wound Healing Group, Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.
authors.forename: Toby
authors.initials: T
authors.lastname: Richards
mesh_terms: D004817:Epidermis / Q000637:transplantation*; D006801:Humans; D011788:Quality of Life; D062326:Re-Epithelialization; D016038:Skin Transplantation / Q000379:methods*; D000078202:Systematic Reviews as Topic; D016896:Treatment Outcome; D014945:Wound Healing; D014947:Wounds and Injuries / Q000601:surgery*
keywords: Epidermal graft; Skin graft; Systematic review; Wound healing