Evaluating the therapeutic efficacy and safety of alginate-based dressings in burn wound and donor site wound management associated with burn surgery: a systematic review and meta-analysis of contemporary randomized controlled trials.

Background: Alginate-based dressings are widely used in burn care for their absorptive and healing properties; however, inconsistencies in clinical outcomes remain.

Methods: This study followed the PRISMA guidelines, we systematically searched PubMed, Embase, Cochrane, and Web of Science for randomized controlled trials (RCTs) comparing alginate dressings to other treatments in burn patients and their donor sites. Inclusion criteria focused on prospective trials with measured outcomes such as healing time, pain scores, dressing change frequency, and adverse events. Data extraction and quality assessment adhered to standardized methods, and meta-analyses were performed using R 4.4.2 and Stata 15.0 with the GRADE approach to evaluate evidence certainty. Data were aggregated and reported as relative risk (RR), mean difference (MD) and standardized mean difference (SMD), with a 95% confidence interval (CI).

Results: Fifteen studies met the inclusion criteria. The meta-analysis revealed a significantly shorter healing time with alginate dressings versus controls, showing a MD of -1.09 days (95% CI: -1.67 to -0.31, p < 0.001, I² = 94.6%). Pain scores also favored alginate dressings, with a SMD of -1.37 (95% CI: -2.53 to -0.21, p = 0.000, I² = 90.9%). There was no significant difference in dressing change frequency, with an SMD of 2.18 (95% CI: -4.29 to -0.07, p = 0.000, I² = 94.0%). Adverse events showed a RR of 0.81 (95% CI: 0.50 to 1.30, p = 0.021, I² = 51.1%), indicating similar safety profiles in both groups.

Conclusion: Our findings indicate that alginate dressings not only significantly reduce healing time but also offer clinically relevant benefits, including reduced pain and fewer dressing changes, making them a valuable option in burn wound management. However, their effect on dressing change frequency and adverse events remains comparable to control treatments. Despite the methodological limitations such as high heterogeneity and potential biases, alginate dressings maintain advantages in clinical settings. Standardization of evaluation criteria and long-term studies are necessary to enhance the understanding and application of alginate dressings in diverse burn wound and donor site wound care settings.