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Published on: February 23, 2024
Paediatric Partial-Thickness Burn Therapy: A Meta-Analysis and Systematic Review of Randomised Controlled Trials
Aba Lőrincz1, Alex Váradi2, Péter Hegyi3,4,5
1Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pécs, 12 Szigeti Street, H7624 Pécs, Hungary.
Insights
New dressings may offer faster healing for paediatric burns compared to silver sulphadiazine (SSD). However, more research is needed to confirm effectiveness due to study variations in burn depth and size.
Area of Science:
- Pediatric Burn Care
- Wound Healing Research
- Dermatology
Background:
- Paediatric second-degree burns present significant medical challenges with potential for severe, lifelong complications.
- Numerous therapeutic options exist, necessitating a comparison of their outcomes against standard treatments like silver sulphadiazine (SSD).
Purpose of the Study:
- To systematically review and meta-analyze randomized controlled trials (RCTs) on dressings for acute paediatric partial-thickness burns.
- To compare the effectiveness of various dressings against silver sulphadiazine (SSD).
Main Methods:
- A meta-analysis and systematic review of RCTs were performed.
- Evaluated endpoints included time to wound closure, grafting rates, infection rates, dressing change frequency, and hospitalisation duration.
Main Results:
- Biosynthetic, silver foam, and amnion membrane dressings showed a trend towards faster healing and reduced complications.
- Significant differences were observed in the number of dressing changes, correlating with reduced pain, need for narcosis, and shorter treatment duration.
Conclusions:
- Heterogeneity in study design (burn depth, surface area) limited definitive conclusions on main outcomes.
- Further research is required to establish the most effective treatment strategies for paediatric partial-thickness burns.
Background:
Paediatric second-degree burn injuries are a significant source of medical challenges to the population that may cause severe, lifelong complications. Currently, there are dozens of therapeutic modalities and we aimed to summarise their reported outcomes and determine their effectiveness, compared to the widely used silver sulphadiazine (SSD).
Methods:
We conducted the meta-analysis and systematic review of randomised controlled trials (RCTs), which investigated the performance of dressings in acute paediatric partial-thickness burns. The evaluated endpoints were time until wound closure, grafting and infection rate, number of dressing changes and length of hospitalisation.
Results:
Twenty-nine RCTs were included in the qualitative and 25 in the quantitative synthesis, but only three trials compared SSD directly to the same intervention (Biobrane). Data analysis showed a tendency for faster healing times and a reduced complication rate linked to biosynthetic, silver foam and amnion membrane dressings. A substantial difference was found between the number of dressing changes associated with less pain, narcosis and treatment duration.
Conclusions:
Considerable between-study heterogeneity was caused by the unequal depth subcategory ratio and surface area of the injuries; therefore, no significant difference was found in the main outcomes. Further research is necessary to establish the most effective treatment for these burns.
