Virtual reality as a pain reduction method in burn and wound healing: a systematic review and meta-analysis

Burns and wounds cause significant physical and psychological distress, with pain being a major barrier to recovery. Traditional pharmacological methods for pain management carry risks such as side effects and dependency. Virtual reality has emerged as a non-invasive, distraction-based technique that may reduce pain perception during wound care by modulating sensory input.

This systematic review and meta-analysis, conducted following PRISMA guidelines and registered in PROSPERO (CRD420251005004), assessed the effectiveness of virtual reality in managing pain during wound and burn care. A comprehensive search of PubMed, Web of Science, Scopus, and Cochrane Library was conducted in March 2025. Eligible studies included randomized controlled trials comparing virtual reality interventions to standard care or other distraction techniques in patients with active wounds or burns. Data on pain outcomes, as well as physiological indicators, were extracted. Meta-analysis was performed using a random-effects model and Hedges' g as the effect size estimator. The analysis was performed with SPSS version 29 and the risk of bias was assessed using the RoB 2.0 tool.

Eleven studies (n = 936 participants) were included, with diverse wound types (burns, surgical, limb injuries) and virtual reality setups, predominantly immersive. The overall pooled effect showed a statistically significant reduction in pain using virtual reality (g = -1.528; 95% CI: -2.259 to -0.797; p < 0.001), indicating a moderate-to-large effect. Subgroup analysis revealed that virtual reality was most effective in children (g = -2.348), followed by adolescents (g = -0.538), while adults showed a non-significant effect (g = -1.453). High heterogeneity (I² = 95.5%) was explained by age group differences and sensitivity analysis. No significant publication bias was detected.

Virtual reality appears to be a promising tool for reducing procedural pain, particularly in children with wounds or burns. Its efficacy in adolescents is moderate, while evidence in adults remains inconclusive. Given its non-pharmacological nature and potential to improve patient experience, virtual reality warrants broader implementation and further age-specific research in wound care settings.