Wasiak J, Cleland H, Campbell F, Spinks A, et al.
The Cochrane database of systematic reviews. Date of publication 2013 Mar 28;volume (3):CD002106.
1. Cochrane Database Syst Rev. 2013 Mar 28;(3):CD002106. doi:
10.1002/14651858.CD002106.pub4.
Dressings for superficial and partial thickness burns.
Wasiak J(1), Cleland H, Campbell F, Spinks A.
Author information:
(1)Victorian Adult Burns Service and School of Public Health and Preventative
Medicine, Monash University, The Alfred Hospital,Melbourne, Australia.
J.Wasiak@alfred.org.au.
Update of
Cochrane Database Syst Rev. 2008;(4):CD002106.
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.
DOI: 10.1002/14651858.CD002106.pub4
PMID: 23543513 [Indexed for MEDLINE]
