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Dressings for superficial and partial thickness burns.

Abstract

BACKGROUND

An acute burn wound is a complex and evolving injury. Extensive burns produce systemic consequences, in addition to local tissue damage. Treatment of partial thickness burn wounds is directed towards promoting healing and a wide variety of dressings are currently available. Improvements in technology and advances in understanding of wound healing have driven the development of new dressings. Dressing selection should be based on their effects on healing, but ease of application and removal, dressing change requirements, cost and patient comfort should also be considered.

OBJECTIVES

To assess the effects of burn wound dressings on superficial and partial thickness burns.

SEARCH METHODS

For this first update we searched The Cochrane Wounds Group Specialised Register (searched 8 November 2012); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 10); Ovid MEDLINE (2008 to October Week 4 2012); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, November 07, 2012); Ovid EMBASE (2008 to 2012 Week 44); AND EBSCO CINAHL (1982 to 2 November 2012).

SELECTION CRITERIA

All randomised controlled trials (RCTs) that evaluated the effects of burn wound dressings on the healing of superficial and partial thickness burns.

DATA COLLECTION AND ANALYSIS

Two authors extracted the data independently using standardised forms. We assessed each trial for internal validity and resolved differences by discussion.

MAIN RESULTS

A total of 30 RCTs are included in this review. Overall both the quality of trial reporting and trial conduct were generally poor and meta analysis was largely precluded due to study heterogeneity or poor data reporting. In the context of this poor quality evidence, silver sulphadiazine (SSD) was consistently associated with poorer healing outcomes than biosynthetic (skin substitute) dressings, silver-containing dressings and silicon-coated dressings. Burns treated with hydrogel dressings appear to heal more quickly than those treated with usual care.

AUTHORS' CONCLUSIONS

There is a paucity of high-quality evidence regarding the effect of different dressings on the healing of superficial and partial thickness burn injuries. The studies summarised in this review evaluated a variety of interventions, comparators and clinical endpoints and all were at risk of bias. It is impossible to draw firm and confident conclusions about the effectiveness of specific dressings, however silver sulphadiazine was consistently associated with poorer healing outcomes than biosynthetic, silicon-coated and silver dressings whilst hydrogel-treated burns had better healing outcomes than those treated with usual care.

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  • Authors+Show Affiliations

    ,

    Victorian Adult Burns Service and School of Public Health and Preventative Medicine, Monash University, The Alfred Hospital,Melbourne, Australia. J.Wasiak@alfred.org.au.

    , ,

    Source

    MeSH

    Bandages
    Bandages, Hydrocolloid
    Burns
    Humans
    Randomized Controlled Trials as Topic
    Silicon Compounds
    Silver Sulfadiazine
    Skin, Artificial
    Wound Healing

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    23543513

    Citation

    Wasiak, Jason, et al. "Dressings for Superficial and Partial Thickness Burns." The Cochrane Database of Systematic Reviews, 2013, p. CD002106.
    Wasiak J, Cleland H, Campbell F, et al. Dressings for superficial and partial thickness burns. Cochrane Database Syst Rev. 2013.
    Wasiak, J., Cleland, H., Campbell, F., & Spinks, A. (2013). Dressings for superficial and partial thickness burns. The Cochrane Database of Systematic Reviews, (3), p. CD002106. doi:10.1002/14651858.CD002106.pub4.
    Wasiak J, et al. Dressings for Superficial and Partial Thickness Burns. Cochrane Database Syst Rev. 2013 Mar 28;(3)CD002106. PubMed PMID: 23543513.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dressings for superficial and partial thickness burns. AU - Wasiak,Jason, AU - Cleland,Heather, AU - Campbell,Fiona, AU - Spinks,Anneliese, Y1 - 2013/03/28/ PY - 2013/4/2/entrez PY - 2013/4/2/pubmed PY - 2013/7/16/medline SP - CD002106 EP - CD002106 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 3 N2 - BACKGROUND: An acute burn wound is a complex and evolving injury. Extensive burns produce systemic consequences, in addition to local tissue damage. Treatment of partial thickness burn wounds is directed towards promoting healing and a wide variety of dressings are currently available. Improvements in technology and advances in understanding of wound healing have driven the development of new dressings. Dressing selection should be based on their effects on healing, but ease of application and removal, dressing change requirements, cost and patient comfort should also be considered. OBJECTIVES: To assess the effects of burn wound dressings on superficial and partial thickness burns. SEARCH METHODS: For this first update we searched The Cochrane Wounds Group Specialised Register (searched 8 November 2012); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 10); Ovid MEDLINE (2008 to October Week 4 2012); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, November 07, 2012); Ovid EMBASE (2008 to 2012 Week 44); AND EBSCO CINAHL (1982 to 2 November 2012). SELECTION CRITERIA: All randomised controlled trials (RCTs) that evaluated the effects of burn wound dressings on the healing of superficial and partial thickness burns. DATA COLLECTION AND ANALYSIS: Two authors extracted the data independently using standardised forms. We assessed each trial for internal validity and resolved differences by discussion. MAIN RESULTS: A total of 30 RCTs are included in this review. Overall both the quality of trial reporting and trial conduct were generally poor and meta analysis was largely precluded due to study heterogeneity or poor data reporting. In the context of this poor quality evidence, silver sulphadiazine (SSD) was consistently associated with poorer healing outcomes than biosynthetic (skin substitute) dressings, silver-containing dressings and silicon-coated dressings. Burns treated with hydrogel dressings appear to heal more quickly than those treated with usual care. AUTHORS' CONCLUSIONS: There is a paucity of high-quality evidence regarding the effect of different dressings on the healing of superficial and partial thickness burn injuries. The studies summarised in this review evaluated a variety of interventions, comparators and clinical endpoints and all were at risk of bias. It is impossible to draw firm and confident conclusions about the effectiveness of specific dressings, however silver sulphadiazine was consistently associated with poorer healing outcomes than biosynthetic, silicon-coated and silver dressings whilst hydrogel-treated burns had better healing outcomes than those treated with usual care. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/23543513/full_citation L2 - https://doi.org/10.1002/14651858.CD002106.pub4 DB - PRIME DP - Unbound Medicine ER -