Hydrotherapy in burn care: Pros, cons and suggestions

Hydrotherapy represents the use of water for medical purpose, being involved in burn wound care since the 17th century. Burn wound cleansing, performed daily, twice a day, or as needed, as part of standard care, should be scheduled by a burn surgeon and supervised by proper specialists. It can be performed by various methods, like shower, immersion, bedside irrigation or wiping. Due to the high risk of cross-contamination, immersion is no longer recommended. Tap water seems to be superior to saline solution in burn wound care, and adjuvants can be added, especially chlorhexidine, povidone-iodine, or special detergents. Disposable plastic sheets use during showering and the following of cleaning protocols for washing areas have decreased the risk of infection. Apart from the wound-cleansing role, hydrotherapy reduces itching and pain, improves wound healing, favors early mobilization and increases patients’ comfort. Controversy persists around the optimal method and appropriate solutions for cleaning burn injuries and clinical studies are further required to solve this matter. In the absence of standardized recommendations, most burn centers are guided by experience.