Abstract
Background
Partial thickness burns are the most common form of thermal burns. Traditionally,
dressing for these burns is simple gauze with silver sulfadiazine (SSD) changed on
a daily basis. Foam dressings have been proposed to offer the advantage of requiring
less frequent dressing change and better absorption of exudates.
Objective
To compare the impact of silver-containing foam dressing to traditional SSD with gauze
dressing on wound healing of partial thickness burns.
Methods
We performed a systematic literature search using PubMed, EMBASE, CINAHL, Web of Science,
Cochrane Library database and Google Scholar for trials comparing traditional SSD
dressings to that of silver-containing foam dressing on wound healing in partial thickness
burns <25% of the body surface area. We excluded studies that enrolled burns involving
head, face, and genitals; burns older than or equal to 36 h, non-thermal burns, and
immunocompromised patients. Quality of trials was assessed using the GRADE criteria.
The main outcome, complete wound healing, is reported as percentages of wound with
complete epithelialization after the follow up period. Relative risks of complete
healing are also reported with respective 95% CI. Time to healing and pain score before,
during, and after dressing change at each follow up visit are compared between the
groups (means with standard deviation or medians with quartiles).
Results
We identified a total of 877 references, of which three randomized controlled trials
(2 combined pediatric and adult trials and 1 adult trial) with a total of 346 patients
met our inclusion criteria. All three trials compared silver-containing foam dressing
to SSD and gauze on partial thickness burns. Moderate quality evidence indicated no
significant difference in wound re-epithelialization between the groups across all
three trials as confidence intervals for the relative risks all crossed 1. Although
pain scores favored foam dressing at the first dressing change (7 days), there was
no significant difference between the groups at the end of the treatment period at
28 days. Time to wound healing was also similar across the three trials with no statistical
difference. Infection rates favored the foam-dressing group, but data were inconsistent.
Conclusion
Moderate quality evidence indicates that there is no significant difference in wound
healing between silver-containing foam dressing and SSD dressing. However, foam has
the added benefit of reduced pain during the early treatment phase and potentially
decreased infection rates.
Keywords
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Article Info
Publication History
Published online: April 11, 2019
Accepted:
April 10,
2019
Received in revised form:
April 9,
2019
Received:
April 1,
2019
Identification
Copyright
© 2019 Published by Elsevier Inc.
