Does the dressing matter in pediatric partial-thickness burns: a systematic review and meta-analysis

Abstract

Superficial partial thickness burns typically receive nonoperative treatment, whereas deep partial thickness burns, which are prone to hypertrophic scarring, are usually managed through debridement followed by autologous split-thickness skin grafting. Various therapies have been developed to prevent wound infection and to enhance wound healing in pediatric partial-thickness burns. However, the choice of dressing by the surgeon can be influenced by various factors. It is worth noting that there is no standardized approach across all burn centers, leading to variations in care practices. To optimize pediatric patient care, a systematic review was conducted following PRISMA guidelines to review existing treatment options for partial thickness burns in children. Outcomes of interest were wound healing time, dressing changes, length of hospital stay, wound infections, need for grafting despite treatment, and hypertrophic scarring. A total of 68 studies with 8199 patients were included. The mean age of the included patients was 3.1 years, and the mean total body surface area of the burns was 15.6 %. Treatment groups included topical agents, bandages, skin analogues, or unclassified. Considering all treatment outcomes evaluated in this systematic review of the literature, non-silver dressings and skin analogues may have some benefit over topical agents in terms of wound healing time, length of hospital stay, hypertrophic scarring, pain management, and cost saving. Dressing changes, wound infections, and need for grafting did not significantly change between various treatments.