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Partial thickness burn5/3/2023 ![]() A histological and bacteriological comparative study conducted by Keswani et al. Apart from honey, alternatives that are being used include boiled potato peel dressings (BPPD), and papaya paste (particularly in West Africa). This is one factor that makes plant-based traditional remedies popular in these countries. Therefore, these hospitals require a wound dressing, which is effective, simple to apply, economical for the patients and hospital, and with a long shelf life. ![]() Hence topical antimicrobial treatments may either be expensive or unavailable for patients. īurn services in LMICs require compromise to deliver the most cost-effective treatment for patients. However, for patients living in LMICs, financial barriers to treatment are common and with a lack of well-trained and equipped burn surgeons in rural areas, surgery can often lead to more harm than benefit. Delayed wound healing may require surgical intervention in the form of excision and skin graft. Additional benefits of faster burn wound healing include decreased risk of joint contractures, stiffness and ultimately quicker rehabilitation for the patient. Reepithelisation which takes greater than 3-4 weeks is a significant risk factor for the development of hypertrophic scars. Previous research has also shown that SSD can come with harmful side effects and slower reepithelisation. When applying our findings to clinical practice, there is a clear contradiction as to why SSD is still widely used as a topical burn treatment option when this systematic review found that honey was more effective in sterilising infected wounds, and no significant difference was established with regards to complete wound healing time. The best topical dressing for superficial and partial thickness burns still remains unclear. Hence, it is paramount that the most efficacious burn wound dressing is made available to all patients to ensure the burn heals as quickly and efficiently as possible. The National Health Service (NHS) estimates that the cost of burn wound care for unhealed wounds is approximately £40,577 per patient over 24 months. The impact of burn injuries on the individual includes loss of occupation, physical disfigurement, decreased quality of life, social isolation, and psychological impairment. Infections to the burn wound correlate to increased wound healing time, hospital length of stay and mortality. This can result in sepsis which accounts for the commonest cause of death in burns patients. Severe burn injuries can also lead to a systemic dampening of the immune response triggered by the injured tissue which further exacerbates infection risk. From a local level, the skin loses its protective capabilities against pathogens, and the moist wound environment provides a favourable home for bacteria to multiply. ![]() The health and socioeconomic implications of burns are staggering. Ideally, this should be conducted in the form of prospective three-arm RCTs in accordance with the CONSORT statement. However, due to the low quality of available studies in this field, further research is necessary to establish the optimum burn dressing. We conclude that honey dressings may be as or more effective than SSD in the treatment of superficial and partial thickness burn injuries. Meta-analysis from five studies highlighted an overall significant difference favouring honey dressing in the proportion of wounds rendered sterile at day 7 post-injury (OR 10.80 95% CI p < 0.00001 I 2 = 88%). From three studies, meta-analysis showed no significant difference in complete wound healing time ( p = 0.06). Seven studies were identified: totalling a population of 582 patients. Quality and risk of bias assessments were performed using the Cochrane RoB2 tool. All studies in the English language that assessed honey versus SSD for patients with superficial or partial thickness burns were included. This review was completed in line with PRISMA guidelines and has been registered with PROSPERO (Study ID: CRD42022337433). The outcomes measures included complete burn wound healing time, the proportion of wounds rendered sterile and subjective pain relief associated with the respective dressing type. We performed a systematic review and meta-analysis using the PubMed, MEDLINE and Embase databases to find relevant randomised control trials (RCTs) for inclusion. This study aimed to assess the efficacy of honey versus silver sulfadiazine dressing (SSD) for the treatment of superficial and partial thickness burns. At present, the best burn wound dressing remains unknown. Burn dressings play a vital role in protecting the patient from infection and aiding in the wound healing process.
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