![]() ![]() In addition, a cream containing Helix Aspersa may slightly increase the proportion of wounds completely healed at 14 days compared with MEBO (RR 4.77, 95% CI 1.87 to 12.15 43 participants). ![]() Low‐certainty evidence shows that MEBO may slightly reduce time to complete wound healing compared with saline soaked dressing (MD –1.7 days, 95% CI –3.32 to –0.08 40 participants). ![]() Single studies show low to very low‐certainty effects of interventions. Miscellaneous treatments versus miscellaneous treatments In contrast, a biological dressing (porcine Xenoderm) might slightly increase pain in superficial burns (MD 1.20, 95% CI 0.65 to 1.75 15 participants (30 wounds)) as well as deep partial thickness burns (MD 3.00, 95% CI 2.34 to 3.66 10 participants (20 wounds)), compared with antimicrobial agents (Physiotulle Ag (Coloplast)). A bioengineered skin substitute may slightly reduce procedural pain (MD –4.00, 95% CI –5.05 to –2.95 34 participants) and background pain (MD –2.00, 95% CI –3.05 to –0.95 34 participants) compared with an unspecified antimicrobial agent. Single studies showed contrasting low‐certainty evidence. Outcomes included wound infection, pain, scar quality, adverse effects of treatment and length of hospital stay. We are uncertain whether skin substitutes in general make any other difference in effects as the evidence is very low certainty. greater than 90%) wound healing, compared with a non‐specified antibacterial agent (MD –6.00 days, 95% CI –8.69 to –3.31 1 study, 34 participants). There is low‐certainty evidence that a skin substitute may slightly reduce time to partial (i.e. Skin substitutes versus topical antimicrobial agents There is low to very low‐certainty evidence for the proportion of facial burns requiring surgery, pain, scar quality, adverse effects and length of hospital stay. There is very low‐certainty evidence regarding whether topical antimicrobial agents make a difference to wound infection (RR 0.73, 95% CI 0.46 to 1.17 1 study, 15 participants). greater than 90%) wound healing (comparison SSD versus cerium SSD: mean difference (MD) –7.10 days, 95% CI –16.43 to 2.23 1 study, 142 participants). For primary outcomes, there is low‐certainty evidence for time to partial (i.e. It is uncertain whether topical antimicrobial agents make any difference in effects as the evidence is low to very low‐certainty. Topical antimicrobial agents versus other topical antimicrobial agents Two studies assessed pain but it was incompletely reported. There is low‐certainty evidence for the secondary outcomes scar quality and patient satisfaction. No trials reported change in wound surface area over time or partial wound healing. We are uncertain whether there is a difference in wound infection (comparison topical antimicrobial agent (Aquacel‐Ag) and MEBO RR 0.38, 95% CI 0.12 to 1.21 1 study, 40 participants very low‐certainty evidence). Topical antimicrobial agents may make little or no difference to the proportion of wounds completely healed compared with topical non‐antimicrobial agents (comparison SSD and MEBO, risk ratio (RR) 0.94, 95% CI 0.68 to 1.29 1 study, 39 participants low‐certainty evidence). There is moderate‐certainty evidence that there is probably little or no difference between antimicrobial agents and non‐antimicrobial agents (SSD and MEBO) in time to complete wound healing (hazard ratio (HR) 0.84 (95% confidence interval (CI) 0.78 to 1.85, 1 study, 39 participants). Topical antimicrobial agents versus topical non‐antimicrobial agents sequence generation and allocation concealment) lack of blinding of participants, providers and sometimes outcome assessors and imprecision resulting from few participants, low event rates or both, often in single studies. Topical agents included antimicrobial agents (silver sulphadiazine (SSD), Aquacel‐Ag, cerium‐sulphadiazine, gentamicin cream, mafenide acetate cream, bacitracin), non‐antimicrobial agents (Moist Exposed Burn Ointment (MEBO), saline‐soaked dressings, skin substitutes (including bioengineered skin substitute (TransCyte), allograft, and xenograft (porcine Xenoderm), and miscellaneous treatments (growth hormone therapy, recombinant human granulocyte‐macrophage colony‐stimulating factor hydrogel (rhGMCS)), enzymatic debridement, and cream with Helix Aspersa extract).Īlmost all the evidence included in this review was assessed as low or very low‐certainty, often because of high risk of bias due to unclear randomisation procedures (i.e. Most trials included adults admitted to specialised burn centres after recent burn injuries. In this first update, we included 12 RCTs, comprising 507 participants. ![]()
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