Burns : journal of the International Society for Burn Injuries
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Post-burn pruritus is one of the most common complaints reported by patients with limited evidence for a gold-standard treatment. ⋯ Current evidence suggests that current modalities have a statistically significant, but not clinically significant, reduction in pruritus. This review highlights the limited quality of evidence in the literature and the poor quality of reporting among excluded studies.
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Review Meta Analysis
Tranexamic acid in burn surgery: A systematic review and meta-analysis.
Burn injury causes a coagulopathy that is poorly understood. After severe burns, significant fluid losses are managed by aggressive resuscitation that can lead to hemodilution. These injuries are managed by early excision and grafting, which can cause significant bleeding and further decrease blood cell concentration. ⋯ Overall, when compared to the control group, TXA significantly reduced total volume blood loss (mean difference (MD) = -192.44; 95% confidence interval (CI) = -297.73 to - 87.14; P = 0.0003), the ratio of blood loss to burn injury total body surface area (TBSA) (MD = -7.31; 95% CI = -10.77 to -3.84; P 0.0001), blood loss per unit area treated (MD = -0.59; 95% CI = -0.97 to -0.20; P = 0.003), and the number of patients receiving a transfusion intraoperatively (risk difference (RD) = -0.16; 95% CI = -0.32 to - 0.01; P = 0.04). Additionally, there were no noticeable differences in venous thromboembolism (VTE) events (RD = 0.00; 95% CI = -0.03 to 0.03; P = 0.98) and mortality (RD = 0.00; 95% CI = -0.03 to 0.04; P = 0.86). In conclusion, TXA can potentially be a pharmacologic intervention that reduces blood losses and transfusions in burn surgery without increasing the risk of VTE events or mortality.
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Our objective was to compare the outcomes of full thickness skin grafts versus split thickness skin grafts in paediatric hand burn patients. A systematic review and meta-analysis were carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines, and an electronic search was conducted to identify all Randomised Controlled Trials and non-randomised studies comparing the outcomes of full thickness skin grafts versus split thickness skin grafts in paediatric hand burn patients. Primary outcomes included development of post-graft contracture and the necessity for surgical release. ⋯ However, split thickness skin grafts, showed to be superior in scar, aesthetic, and colour assessments, and less hair growth was observed for split thickness skin grafts. No significant difference was seen in sensation and donor or recipient site complaints. Overall, full thickness skin grafts are a better alternative for paediatric hand burns than split thickness skin transplants because they are linked with reduced post-graft contracture and the requirement for surgical release.
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Review Meta Analysis
Wound contraction rate in excised and unexcised burn wounds with laser photobiomodulation: Systematic review and meta-analysis of preclinical studies.
Laser photobiomodulation (laser PBM) is an effective means of accelerating burn wound contraction, however it is still unclear whether laser PBM produces greater benefit when applied directly to excised and unexcised burn wounds . The aim of this systematic review of preclinical studies was to determine the effectiveness of laser PBM in the wound contraction rate in excised and unexcised burn wounds. ⋯ In the animal model, laser PBM is effective in increasing the wound contraction rate in excised burns. However, due to the low certainty of the evidence, uncertainty remains about the true magnitude of the effect of laser on wound contraction in animals; our results should therefore be interpreted with caution.