A Cochrane review [Abstract] 1 included 30 studies. Overall both the quality of trial reporting and trial conduct were generally poor and meta analysis was largely precluded due to study heterogeneity or poor data reporting. In the context of this poor quality evidence, silver sulphadiazine (SSD) was consistently associated with poorer healing outcomes than biosynthetic (skin substitute) dressings, silver-containing dressings and silicon-coated dressings. Burns treated with hydrogel dressings appear to heal more quickly than those treated with usual care.
A topic in Clinical Evidence 2 summarizes the results of three RCTs. One RCT (n=42) found that compared with silver sulfadiazine dressing, hydrocolloid dressing reduced time to wound healing (10.23 days vs 15.59 days, p<0.01) pain (p<0.01) and limitation of activity (p<0.01). The second RCT found that a silicone coated nylon net dressing resulted in shorter mean healing time compared with silver sulfadiazine dressing (7.58 days vs 11.26 days, p<0.01). The results were confirmed in a rapid review of 12 studies 3.
Comment: The quality of evidence is downgraded by limitations in study quality (inadequate or unclear allocation concealment and blinding methods, poor definition and measurement of outcomes, poor reporting) and by imprecise results (limited study size for each comparison).
Primary/Secondary Keywords