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Kamrani P, Hedrick J, Marks JG, Zaenglein AL. Petroleum jelly: A comprehensive review of its history, uses, and safety. J Am Acad Dermatol 2024; 90:807-813. [PMID: 37315800 DOI: 10.1016/j.jaad.2023.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/28/2023] [Accepted: 06/01/2023] [Indexed: 06/16/2023]
Abstract
Petrolatum, also known as petroleum jelly, is a widely used topical agent, with a variety of uses in dermatology. Despite its popularity, many myths surround this ubiquitous dermatologic staple. This review details the history of petrolatum and how it is manufactured as well as how its biologic properties make it a great moisturizer. Additionally, data on its potential for flammability, allergenicity, and comedogenicity are detailed, dispelling misconceptions about petrolatum use around oxygen and as a cause of acne. The uses and benefits of petrolatum in dermatology are wide-ranging-a patch test instrument, a vehicle for medicated ointments, and a wound care essential. Given its ubiquitous presence, it is important for dermatologists to understand the history, safety profile, and myths surrounding this humble skincare staple.
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Affiliation(s)
- Payvand Kamrani
- Department of Dermatology, Penn State/Hershey Medical Center, Hershey, Pennsylvania.
| | - Jamie Hedrick
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - James G Marks
- Department of Dermatology, Penn State/Hershey Medical Center, Hershey, Pennsylvania
| | - Andrea L Zaenglein
- Department of Dermatology, Penn State/Hershey Medical Center, Hershey, Pennsylvania; Department of Pediatrics, Penn State Children's Hospital, Hershey, Pennsylvania
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2
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Ji S, Xiao S, Xia Z. Consensus on the treatment of second-degree burn wounds (2024 edition). BURNS & TRAUMA 2024; 12:tkad061. [PMID: 38343901 PMCID: PMC10858447 DOI: 10.1093/burnst/tkad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/29/2023] [Accepted: 12/08/2023] [Indexed: 02/21/2024]
Abstract
Second-degree burns are the most common type of burn in clinical practice and hard to manage. Their treatment requires not only a consideration of the different outcomes that may arise from the dressing changes or surgical therapies themselves but also an evaluation of factors such as the burn site, patient age and burn area. Meanwhile, special attention should be given to the fact that there is no unified standard or specification for the diagnosis, classification, surgical procedure, and infection diagnosis and grading of second-degree burn wounds. This not only poses great challenges to the formulation of clinical treatment plans but also significantly affects the consistency of clinical studies. Moreover, currently, there are relatively few guidelines or expert consensus for the management of second-degree burn wounds, and no comprehensive and systematic guidelines or specifications for the treatment of second-degree burns have been formed. Therefore, we developed the Consensus on the Treatment of Second-Degree Burn Wounds (2024 edition), based on evidence-based medicine and expert opinion. This consensus provides specific recommendations on prehospital first aid, nonsurgical treatment, surgical treatment and infection treatment for second-degree burns. The current consensus generated a total of 58 recommendations, aiming to form a standardized clinical treatment plan.
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Affiliation(s)
- Shizhao Ji
- Correspondence: Shizhao Ji, ; Shichu Xiao, ; Zhaofan Xia,
| | - Shichu Xiao
- Correspondence: Shizhao Ji, ; Shichu Xiao, ; Zhaofan Xia,
| | - Zhaofan Xia
- Correspondence: Shizhao Ji, ; Shichu Xiao, ; Zhaofan Xia,
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3
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"Spin" in Plastic Surgery Randomized Controlled Trials with Statistically Nonsignificant Primary Outcomes: A Systematic Review. Plast Reconstr Surg 2023; 151:506e-519e. [PMID: 36442055 DOI: 10.1097/prs.0000000000009937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND "Spin" refers to a manipulation of language that implies benefit for an intervention when none may exist. Randomized controlled trials (RCTs) in other fields have been demonstrated to employ spin, which can mislead clinicians to use ineffective or unsafe interventions. This study's objective was to determine the strategies, severity, and extent of spin in plastic surgery RCTs with nonsignificant primary outcomes. METHODS A literature search of the top 15 plastic surgery journals using MEDLINE was performed (2000 through 2020). Parallel 1:1 RCTs with a clearly identified primary outcome showing statistically nonsignificant results ( P > 0.05) were included. Screening, data extraction, and spin analysis were performed by two independent reviewers. The spin analysis was then independently assessed in duplicate by two plastic surgery residents with graduate-level training in clinical epidemiology. RESULTS From 3497 studies identified, 92 RCTs were included in this study. Spin strategies were identified in 78 RCTs (85%), including 64 abstracts (70%) and 77 main texts (84%). Severity of spin was rated moderate or high in 43 abstract conclusions (47%) and 42 main text conclusions (46%). The most identified spin strategy in the abstract was claiming equivalence for statistically nonsignificant results (26%); in the main text, focusing on another objective (24%). CONCLUSIONS This study suggests that 85% of statistically nonsignificant RCTs in plastic surgery employ spin. Readers of plastic surgery research should be aware of strategies, whether intentional or unintentional, used to manipulate language in reports of statistically nonsignificant RCTs when applying research findings to clinical practice.
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Badr P, Afsharypuor S, Tohidinik HR, Mohammadi AA, Daneshamouz S. Burn Wound Healing Effect of a Sterilized Traditional Formulation of Boswellia carteri vs. Silver Sulfadiazine Cream 1% in Patients Presenting Second-degree Burn Wounds: A Randomized, Double-blind Clinical Trial. IRANIAN JOURNAL OF MEDICAL SCIENCES 2023; 48:137-145. [PMID: 36895452 PMCID: PMC9989234 DOI: 10.30476/ijms.2022.91853.2307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 12/01/2021] [Accepted: 01/30/2022] [Indexed: 03/11/2023]
Abstract
Background Burn wounds rank among the most serious healthcare issues. Many studies reported the effectiveness of natural products in the wound-healing process. The present study compared the effects of a standardized herbal formulation derived from Boswellia carteri (B. carteri) and silver sulfadiazine (SSD) cream 1% on the healing of burn wounds. Methods This randomized double-blind clinical trial was conducted at Shiraz Burn Hospital (Shiraz, Iran) between July 2012 to August 2013. A sterilized formulation comprising B. carteri 40% was prepared. 54 second-degree burn patients of both sexes with age ranges of 20 to 60 were invited to participate in this double-blind, randomized clinical trial. They were randomly divided into two groups and given either the Boswellia formulation or SSD cream. The healing index was determined based on the wound area assessment using the planimetry technique. The Kaplan-Meier survival analysis was used to assess the primary outcome, which was the amount of time until complete healing. Results The trial was completed by 17 patients from the SSD group and 15 patients from the Boswellia group. During the study period, both groups showed a progressive healing trend. The mean (95% CI) healing time in the SSD group was 10.94 (9.03-12.85) days and 10.73 (9.23-12.23) days in the Boswellia group (P=0.71), indicating no significant difference. On the 17th day, the healing index of all patients in the Boswellia group reached 1. Conclusion Boswellia topical formulation had a burn wound healing effect comparable to that of the standard SSD 1% treatment. Based on the findings of this study, the likelihood of contact dermatitis with Boswellia should be taken into consideration.
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Affiliation(s)
- Parmis Badr
- Pharmaceutical Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Suleiman Afsharypuor
- Department of Pharmacognosy, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Reza Tohidinik
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Mohammadi
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Division of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeid Daneshamouz
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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5
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Cook KA, Martinez-Lozano E, Sheridan R, Rodriguez EK, Nazarian A, Grinstaff MW. Hydrogels for the management of second-degree burns: currently available options and future promise. BURNS & TRAUMA 2022; 10:tkac047. [PMID: 36518878 PMCID: PMC9733594 DOI: 10.1093/burnst/tkac047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/14/2022] [Accepted: 09/30/2022] [Indexed: 12/13/2022]
Abstract
Burn wounds result from exposure to hot liquids, chemicals, fire, electric discharge or radiation. Wound severity ranges from first-degree injury, which is superficial, to fourth-degree injury, which exposes bone, tendons and muscles. Rapid assessment of burn depth and accurate wound management in the outpatient setting is critical to prevent injury progression into deeper layers of the dermis. Injury progression is of particular pertinence to second-degree burns, which are the most common form of thermal burn. As our understanding of wound healing advances, treatment options and technologies for second-degree burn management also evolve. Polymeric hydrogels are a class of burn wound dressings that adhere to tissue, absorb wound exudate, protect from the environment, can be transparent facilitating serial wound evaluation and, in some cases, enable facile removal for dressing changes. This review briefly describes the burn level classification and common, commercially available dressings used to treat second-degree burns, and then focuses on new polymeric hydrogel burn dressings under preclinical development analyzing their design, structure and performance. The review presents the follow key learning points: (1) introduction to the integument system and the wound-healing process; (2) classification of burns according to severity and clinical appearance; (3) available dressings currently used for second-degree burns; (4) introduction to hydrogels and their preparation and characterization techniques; and (5) pre-clinical hydrogel burn wound dressings currently being developed.
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Affiliation(s)
- Katherine A Cook
- Department of Chemistry, Biomedical Engineering, and Medicine, Boston University, Boston, MA, 02215, USA
| | - Edith Martinez-Lozano
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - Robert Sheridan
- Shriners Hospitals for Children and Burns Service, Department of Surgery, Massachusetts General Hospital, Boston, MA, 02214, USA
| | - Edward K Rodriguez
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - Ara Nazarian
- Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
- Department of Orthopaedic Surgery, Yerevan State Medical University, Yerevan, Armenia
| | - Mark W Grinstaff
- Department of Chemistry, Biomedical Engineering, and Medicine, Boston University, Boston, MA, 02215, USA
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6
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Characterization of Tattoo Aftercare Products: Allergenic Ingredients and Marketing Claims. Dermatitis 2021; 32:301-307. [PMID: 34524774 DOI: 10.1097/der.0000000000000635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Common recommendations for tattoo aftercare to ensure proper healing include application of topical products. Little is known about tattoo aftercare products. METHODS Tattoo aftercare products were identified from a previous study and a search on Amazon.com using the phrase "tattoo aftercare." Duplicates and products without complete ingredient lists were excluded. Marketing claims were tabulated. All ingredients were entered in Excel and grouped according to Contact Allergen Management Program categories. Comparison of ingredients to North American Contact Dermatitis Group (NACDG) screening and American Contact Dermatitis Society (ACDS) Core allergens was conducted. RESULTS A total of 84 tattoo aftercare products from 52 distinct brands were found. Forty-eight distinctive market claims were identified; the use of "natural ingredient(s)" (42.9%) was most common. There were 4 to 28 ingredients per product (mean = 11.8 ± 5.5) with a total of 369 distinct ingredients listed. Products contained an average of 7.9 ± 3.9 ACDS Core allergens per product and 7.0 ± 3.7 NACDG allergens per product. Most common allergens included fragrance/botanicals (n = 529), vitamin E derivatives (n = 43), and vitamin B5 derivatives (n = 11). CONCLUSIONS This review of 84 products found that tattoo aftercare products contain an average of 8 ACDS Core and 7 NACDG allergens. Clinicians should be aware of potential allergens in tattoo aftercare products.
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Ladhani HA, Young BT, Posillico SE, Yowler CJ, Brandt CP, Claridge JA, Khandelwal AK. Risk Factors for Wound Infection in Outpatients With Lower Extremity Burns. Am Surg 2020; 87:1118-1125. [PMID: 33334142 DOI: 10.1177/0003134820952387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We sought to evaluate risk factors for wound infection in patients with lower extremity (LE) burn. METHODS Adults presenting with LE burn from January 2014 to July 2015 were included. Data regarding demographics, injury characteristics, and outcomes were obtained. The primary outcome was wound infection. Multivariate logistic regression analysis was performed to identify independent risk factors for wound infection. RESULTS 317 patients were included with a mean age of 43 years and median total body surface area of .8%; 22 (7%) patients had a component of full-thickness (FT) burn; and 212 (67%) patients had below-the-knee (BTK) burn. The incidence of wound infection was 15%. The median time to infection was 5 days, and majority (61%) of the patients developed wound infection by day 5. Patients who developed wound infection were more likely to have an FT burn (22% vs. 5%, P < .001) and BTK burn (87% vs. 64%, P = .002), without a difference in other variables. Multivariate logistic regression analysis showed age (Odds ratio (OR) 1.02 and CI 1.00-1.04), presence of FT burn (OR 5.33 and CI 2.09-13.62), and BTK burn (OR 3.42 and CI 1.37-8.52) as independent risk factors for wound infection (area under the curve = .72). CONCLUSION Age, presence of FT burn, and BTK burn are independent risk factors for wound infection in outpatients with LE burns.
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Affiliation(s)
- Husayn A Ladhani
- Department of Surgery, Division of Trauma, Critical Care, Burn and Acute Care Surgery, MetroHealth Medical Center, OH, USA.,School of Medicine, Case Western Reserve University, OH, USA
| | - Brian T Young
- Department of Surgery, Division of Trauma, Critical Care, Burn and Acute Care Surgery, MetroHealth Medical Center, OH, USA.,School of Medicine, Case Western Reserve University, OH, USA
| | - Sarah E Posillico
- Department of Surgery, Division of Trauma, Critical Care, Burn and Acute Care Surgery, MetroHealth Medical Center, OH, USA.,School of Medicine, Case Western Reserve University, OH, USA
| | - Charles J Yowler
- Department of Surgery, Division of Trauma, Critical Care, Burn and Acute Care Surgery, MetroHealth Medical Center, OH, USA.,School of Medicine, Case Western Reserve University, OH, USA
| | - Christopher P Brandt
- Department of Surgery, Division of Trauma, Critical Care, Burn and Acute Care Surgery, MetroHealth Medical Center, OH, USA.,School of Medicine, Case Western Reserve University, OH, USA
| | - Jeffrey A Claridge
- Department of Surgery, Division of Trauma, Critical Care, Burn and Acute Care Surgery, MetroHealth Medical Center, OH, USA.,School of Medicine, Case Western Reserve University, OH, USA
| | - Anjay K Khandelwal
- Department of Surgery, Division of Trauma, Critical Care, Burn and Acute Care Surgery, MetroHealth Medical Center, OH, USA.,School of Medicine, Case Western Reserve University, OH, USA
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8
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Handayani E, Masithoh RF. A small-scale re-evaluation of the efficacy of silver sulfadiazine for burns. Br J Community Nurs 2020; 25:S34-S38. [PMID: 33300848 DOI: 10.12968/bjcn.2020.25.sup12.s34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Burns remain one of the most common injuries contributing to an increase in trauma incidence in hospitals, particularly in developing countries. Therefore, it is essential to identify the appropriate care for these wounds. Silver sulfadiazine has been widely used for the treatment of burns, but its efficacy has not been re-evaluated in recent years. Therefore, this small-scale study aimed at re-evaluating the use of silver sulfadiazine in patients with burns at a hospital in Magelang, Indonesia. A total of seven patients with second- and third-degree burns were involved and received silver sulfadiazine for 5 months (March to July 2020). Data on their wounds were collected three times and evaluated by using the Nursing Outcomes Classification (NOC) observation method. Wound outcomes were evaluated using on the basis of wound healing by secondary intention. Silver sulfadiazine was found to be effective; 85.7% of the wound area showed granulation tissue, and 75-100% of the wound area showed epithelialisation. However, patients complained of pain during silver sulfadiazine treatment. Therefore, additional nursing interventions seem to be needed to manage burns.
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Affiliation(s)
- Estrin Handayani
- both from the Department of Medical Surgical Nursing, Universitas Muhammadiyah Magelang, Indonesia
| | - Robiul Fitri Masithoh
- both from the Department of Medical Surgical Nursing, Universitas Muhammadiyah Magelang, Indonesia
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9
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Davies A, Spickett-Jones F, Jenkins A, Young A. A systematic review of intervention studies demonstrates the need to develop a minimum set of indicators to report the presence of burn wound infection. Burns 2020; 46:1487-1497. [DOI: 10.1016/j.burns.2020.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/15/2019] [Accepted: 03/20/2020] [Indexed: 01/29/2023]
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10
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Kawano Y, Jordan O, Hanawa T, Borchard G, Patrulea V. Are Antimicrobial Peptide Dendrimers an Escape from ESKAPE? Adv Wound Care (New Rochelle) 2020; 9:378-395. [PMID: 32320368 PMCID: PMC7307686 DOI: 10.1089/wound.2019.1113] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/18/2020] [Indexed: 12/16/2022] Open
Abstract
Significance: The crisis of antimicrobial resistance (AMR) increases dramatically despite all efforts to use available antibiotics or last resort antimicrobial agents. The spread of the AMR, declared as one of the most important health-related issues, warrants the development of new antimicrobial strategies. Recent Advances: Antimicrobial peptides (AMPs) and AMP dendrimers (AMPDs), as well as polymer dendrimers are relatively new and promising strategies with the potential to overcome drug resistance issues arising in ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) colonizing chronic wounds. Critical Issues: AMPs-AMPDs suffer from limited efficacy, short-lasting bioactivity, and concerns of toxicity. To circumvent these drawbacks, their covalent coupling to biopolymers and/or encapsulation into different drug carrier systems is investigated, with a special focus on topical applications. Future Directions: Scientists and the pharmaceutical industry should focus on this challenging subject to either improve the activity of existing antimicrobial agents or find new drug candidates. The focus should be put on the discovery of new drugs or the combination of existing drugs for a better synergy, taking into account all kinds of wounds and existing pathogens, and more specifically on the development of next-generation antimicrobial peptides, encompassing the delivery carrier toward improved pharmacokinetics and efficacy.
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Affiliation(s)
- Yayoi Kawano
- Laboratory of Preformulation Study, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan
| | - Olivier Jordan
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Takehisa Hanawa
- Laboratory of Preformulation Study, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan
| | - Gerrit Borchard
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Viorica Patrulea
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
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Khansa I, Schoenbrunner AR, Kraft CT, Janis JE. Silver in Wound Care-Friend or Foe?: A Comprehensive Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2390. [PMID: 31592393 PMCID: PMC6756674 DOI: 10.1097/gox.0000000000002390] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/19/2019] [Indexed: 12/12/2022]
Abstract
Due to its strong antimicrobial activity, silver is a commonly used adjunct in wound care. However, it also has the potential to impair healing by exerting toxic effects on keratinocytes and fibroblasts. The published literature on the use of silver in wound care is very heterogeneous, making it difficult to generate useful treatment guidelines. METHODS A search of high-quality studies on the use of silver in wound care was performed on PubMed. A detailed qualitative analysis of published articles was performed to evaluate the evidence for the use of silver in infected wounds, clean wounds, burns, and over closed surgical incisions. RESULTS Fifty-nine studies were included in this qualitative analysis. We found that, overall, the quality of the published research on silver is poor. While there is some evidence for short-term use of dressings containing nanocrystalline silver in infected wounds, the use of silver-containing dressings in clean wounds and over closed surgical incisions is not indicated. Negative-pressure wound therapy accelerates the healing of contaminated wounds, especially when silver is used as an adjunct. For burns, silver sulfadiazine slows healing and should not be used. Instead, nanocrystalline silver, or alternatives such as octenidine and polyhexanide, lead to less infection and faster healing. CONCLUSIONS In infected wounds, silver is beneficial for the first few days/weeks, after which nonsilver dressings should be used instead. For clean wounds and closed surgical incisions, silver confers no benefit. The ideal silver formulations are nanocrystalline silver and silver-coated polyurethane sponge for negative-pressure wound therapy. Silver sulfadiazine impairs wound healing. Proper use of silver-containing dressings is essential to optimize wound healing.
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Affiliation(s)
- Ibrahim Khansa
- From the Division of Plastic and Reconstructive Surgery, Nationwide Children’s Hospital, Columbus, Ohio
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Anna R. Schoenbrunner
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Casey T. Kraft
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jeffrey E. Janis
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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12
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Maciel ABDS, Ortiz JF, Siqueira BS, Zanette GF. Tissue healing efficacy in burn patients treated with 1% silver sulfadiazine versus other treatments: a systematic review and meta-analysis of randomized controlled trials. An Bras Dermatol 2019; 94:204-210. [PMID: 31090826 PMCID: PMC6486072 DOI: 10.1590/abd1806-4841.20198321] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 08/27/2018] [Indexed: 01/09/2023] Open
Abstract
This study aims to evaluate tissue healing efficacy in burn patients treated with 1% silver sulfadiazine versus other treatments. This is a systematic literature review and meta-analysis of randomized clinical trials performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) and PICO strategy, registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42017081057. The review found 71 studies in MEDLINE/Pubmed, 1 in Clinical Trials, 19 in the Cochrane Library, and 4 in LILACS in five manual searches. Of these, 81 studies were pre-selected. After independent analysis by two reviewers, only 11 studies met the inclusion criteria for the review. All studies (n = 11) using alternative treatments to silver sulfadiazine were shown to be superior in the mean time for complete wound healing, with statistically significant differences between experimental and control groups (p <0.00001); mean difference (- 4.26), 95% CI [- 5.96, - 2.56].
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Affiliation(s)
| | - Josmar França Ortiz
- Graduate Studies Program in Cardiology and Hemodynamics,
Faculdade Metropolitana de Manaus, Manaus (AM), Brazil
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13
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Young AE, Davies A, Bland S, Brookes S, Blazeby JM. Systematic review of clinical outcome reporting in randomised controlled trials of burn care. BMJ Open 2019; 9:e025135. [PMID: 30772859 PMCID: PMC6398699 DOI: 10.1136/bmjopen-2018-025135] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Systematic reviews collate trial data to provide evidence to support clinical decision-making. For effective synthesis, there must be consistency in outcome reporting. There is no agreed set of outcomes for reporting the effect of burn care interventions. Issues with outcome reporting have been identified, although not systematically investigated. This study gathers empirical evidence on any variation in outcome reporting and assesses the need for a core outcome set for burn care research. METHODS Electronic searches of four search engines were undertaken from January 2012 to December 2016 for randomised controlled trials (RCTs), using medical subject headings and free text terms including 'burn', 'scald' 'thermal injury' and 'RCT'. Two authors independently screened papers, extracted outcomes verbatim and recorded the timing of outcome measurement. Duplicate outcomes (exact wording ± different spelling), similar outcomes (albumin in blood, serum albumin) and identical outcomes measured at different times were removed. Variation in outcome reporting was determined by assessing the number of unique outcomes reported across all included trials. Outcomes were classified into domains. Bias was reduced using five researchers and a patient working independently and together. RESULTS 147 trials were included, of which 127 (86.4%) were RCTs, 13 (8.8%) pilot studies and 7 (4.8%) RCT protocols. 1494 verbatim clinical outcomes were reported; 955 were unique. 76.8% of outcomes were measured within 6 months of injury. Commonly reported outcomes were defined differently. Numbers of unique outcomes per trial varied from one to 37 (median 9; IQR 5,13). No single outcome was reported across all studies demonstrating inconsistency of reporting. Outcomes were classified into 54 domains. Numbers of outcomes per domain ranged from 1 to 166 (median 11; IQR 3,24). CONCLUSIONS This review has demonstrated heterogeneity in outcome reporting in burn care research which will hinder amalgamation of study data. We recommend the development of a Core Outcome Set. PROSPERO REGISTRATION NUMBER CRD42017060908.
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Affiliation(s)
- Amber E Young
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Anna Davies
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Sara Brookes
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Cancer Research UK Clinical Trials Unit (CRCTU), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Jane M Blazeby
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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14
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Frew Q, Rennekampff HO, Dziewulski P, Moiemen N, Zahn T, Hartmann B. Betulin wound gel accelerated healing of superficial partial thickness burns: Results of a randomized, intra-individually controlled, phase III trial with 12-months follow-up. Burns 2018; 45:876-890. [PMID: 30559054 DOI: 10.1016/j.burns.2018.10.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/23/2018] [Accepted: 10/25/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Acceleration of wound healing promises advantages for patients and caregivers in reducing the burden of disease, avoiding complications such as wound infections, and improving the long-term outcome. However, medicines that can accelerate wound healing are lacking. The objective of this open, blindly evaluated, randomized, multicenter phase III study was to compare intra-individually the efficacy and tolerability of Oleogel-S10 with fatty gauze dressing versus Octenilin® wound gel with fatty gauze dressing in accelerating the healing of superficial partial thickness burn wounds. METHODS Acute superficial partial thickness burn wounds in adults caused by fire, heat burn or scalding were divided into 2 halves and randomly assigned to treatment with Oleogel-S10 or Octenilin® wound gel. Photos for observer-blinded analysis of wound healing were taken at each wound dressing change. Percentages of reepithelialization were assessed at defined intervals. Efficacy and tolerability were evaluated based on a 5-point Likert scale. RESULTS Of 61 patients that were enrolled, 57 received the allocated intervention and 48 completed treatment. The percentage of patients with earlier wound healing was significantly higher for Oleogel-S10 (85.7%, n=30) compared to Octenilin® wound gel (14.3%, n=5, p<0.0001). The mean intra-individual difference in time to wound closure was -1.0 day in favour of Oleogel-S10 (-1.4, -0.6; 95% CI, p<0.0001). Most investigators (87.0%) and patients (84.8%) evaluated the efficacy of Oleogel-S10 to be 'better' or 'much better' than that of Octenilin® wound gel. Long-term outcome 3 months and 12 months post injury was improved in some patients. CONCLUSIONS Oleogel-S10 (Episalvan) significantly accelerated the healing of superficial partial thickness burn wounds. It was safe and well tolerated.
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Affiliation(s)
- Quentin Frew
- St. Andrew's Centre for Plastic Surgery and Burns, Mid Essex Hospitals Trust, Broomfield Hospital, Chelmsford, UK
| | | | - Peter Dziewulski
- St. Andrew's Centre for Plastic Surgery and Burns, Mid Essex Hospitals Trust, Broomfield Hospital, Chelmsford, UK
| | - Naiem Moiemen
- Burns and Plastics, University Hospitals Birmingham NHS Foundation Trust Queen Elisabeth Hospital, Birmingham, UK
| | | | - Bernd Hartmann
- Burn Center with Plastic Surgery, Unfallkrankenhaus Berlin, Germany.
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Hadrup N, Sharma AK, Loeschner K. Toxicity of silver ions, metallic silver, and silver nanoparticle materials after in vivo dermal and mucosal surface exposure: A review. Regul Toxicol Pharmacol 2018; 98:257-267. [DOI: 10.1016/j.yrtph.2018.08.007] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/13/2018] [Accepted: 08/14/2018] [Indexed: 12/30/2022]
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Nímia HH, Carvalho VF, Isaac C, Souza FÁ, Gemperli R, Paggiaro AO. Comparative study of Silver Sulfadiazine with other materials for healing and infection prevention in burns: A systematic review and meta-analysis. Burns 2018; 45:282-292. [PMID: 29903603 DOI: 10.1016/j.burns.2018.05.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 04/11/2018] [Accepted: 05/17/2018] [Indexed: 01/09/2023]
Abstract
The aim of this systematic review with meta-analysis was to compare the effect of Silver Sulfadiazine (SSD) with other new dressings, with or without silver, on healing and infection prevention in burns. The electronic search was carried out in the electronic databases of Pubmed, ScienceDirect, Lilacs and BVS. The articles included were randomized clinical trials about burn treatment with SSD, which evaluated the healing and infection of burn wounds in humans. The exclusion criteria included articles, editorials and letters published in the form of abstracts, unpublished reports and case series, cross-sectional, observational experimental studies, and the use of sulfadiazine for other types of wounds. The search identified 873 references, and 24 studies were included in accordance with the eligibility criteria. The results showed a statistically favorable difference related to the time of healing for silver dressings (p<0.0001; MD 3.83; 95% CI 2.03-5.62) and dressings without silver (p<0.007; MD 2.9; 95% CI 0.81-5.00) in comparison with SSD. The rate of infection showed no difference in the group treated with SSD compared with the group treated with dressings containing silver (p>0.05). The rate of infection was significantly higher in the SSD group compared with the group treated with dressings without silver (p<0.005; MD 25.29% and MD 12.97%). Considering the clinical trials conducted up to the present time, the authors concluded that new dressings with and without silver show better results than SSD for wound healing, and burns treated with dressings without silver are less likely to become infected than burns with SSD. No differences between SSD and new silver materials were observed in relation to infection prevention.
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Affiliation(s)
- Heloisa Helena Nímia
- Guarulhos University, Nursing Post, Graduation Program, Praça Tereza Cristina, 88, Centro, Guarulhos, SP, 07020-071, Brazil.
| | - Viviane Fernandes Carvalho
- Guarulhos University, Nursing Post, Graduation Program, Praça Tereza Cristina, 88, Centro, Guarulhos, SP, 07020-071, Brazil.
| | - Cesar Isaac
- São Paulo University, Plastic Surgery Division, Av. Dr. Arnaldo, 455, Cerqueira César, São Paulo, SP, 01246-903, Brazil.
| | - Francisley Ávila Souza
- Dentistry College, UNESP, Rua José Bonifácio, 1193, Araçatuba, São Paulo, SP, 16015-050, Brazil.
| | - Rolf Gemperli
- São Paulo University, Plastic Surgery Division, Av. Dr. Arnaldo, 455, Cerqueira César, São Paulo, SP, 01246-903, Brazil.
| | - André Oliveira Paggiaro
- Guarulhos University, Nursing Post, Graduation Program, Praça Tereza Cristina, 88, Centro, Guarulhos, SP, 07020-071, Brazil.
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Deuschle VCKN, Brusco I, Piana M, Faccin H, de Carvalho LM, Oliveira SM, Viana C. Persea americana Mill. crude extract exhibits antinociceptive effect on UVB radiation-induced skin injury in mice. Inflammopharmacology 2018; 27:323-338. [DOI: 10.1007/s10787-018-0441-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 01/03/2018] [Indexed: 01/02/2023]
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Bitter CC, Erickson TB. Management of Burn Injuries in the Wilderness: Lessons from Low-Resource Settings. Wilderness Environ Med 2016; 27:519-525. [DOI: 10.1016/j.wem.2016.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 07/27/2016] [Accepted: 09/02/2016] [Indexed: 01/22/2023]
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19
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Nasiri E, Hosseinimehr SJ, Zaghi Hosseinzadeh A, Azadbakht M, Akbari J, Azadbakht M. The effects of Arnebia euchroma ointment on second-degree burn wounds: a randomized clinical trial. JOURNAL OF ETHNOPHARMACOLOGY 2016; 189:107-116. [PMID: 27180881 DOI: 10.1016/j.jep.2016.05.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 05/11/2016] [Accepted: 05/11/2016] [Indexed: 06/05/2023]
Abstract
ETHNOBOTANICAL RELEVANCE Burn injuries can cause detrimental long-term consequences and call for immediate management. Avicenna's Canon of Medicine, describing the use of Abu-Khalsa (Arnebia euchroma) (AE) as being effective for burn healing. The purpose of this study was to evaluate the healing effects of AE ointment (AEO) on patients with a second-degree burn wound and compare its results with silver sulfadiazine cream (SSD). MATERIALS AND METHODS In this prospective, single-blind clinical trial, 45 patients with similar types of second-degree burns at two different sites of the body were randomly assigned to the two treatment groups. One burn wound site of the patient was treated with SSD and another similar burn wound site with AEO once a day until complete healing was achieved. Wound size and percentage of wound healing were evaluated at 15 days. Satisfaction, clinical adverse events such as pain, burning, warming, erythema, edema, infection, inflammation, and general wound area were assessed on a visual analogue scales, and 6-point scales. RESULTS The healing time was significantly shorter in the site treated with AEO than SSD (13.9±5.3 vs. 17.5±6.9 days, respectively). The severity of pain and burning were reduced in the AEO site compared with SSD site at the time of dressing change, while the warming score was significantly higher in the AEO wound area. Side-effects were lower in the site treated with AEO. CONCLUSION In this clinical study, we demonstrated that AEO has benefits over SSD in the treatment of second-degree burn wounds and wound healing and is a viable medication for the management of second-degree burns.
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Affiliation(s)
- Ebrahim Nasiri
- Traditional and Complementary Medicine Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Faculty of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Jalal Hosseinimehr
- Traditional and Complementary Medicine Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Ahmad Zaghi Hosseinzadeh
- Department of Plastic Surgery, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Azadbakht
- Traditional and Complementary Medicine Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jafar Akbari
- Traditional and Complementary Medicine Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran; Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
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Silver Sulfadiazine Retards Wound Healing in Mice via Alterations in Cytokine Expression. J Invest Dermatol 2015; 135:1459-1462. [DOI: 10.1038/jid.2015.21] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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