It was often uncertain whether antiseptics were associated with any difference in healing, infections, or other outcomes. Where there is moderate or high certainty evidence, decision makers need to consider the applicability of the evidence from the comparison to their patients. Reporting was poor, to the extent that we are not confident that most trials are free from risk of bias.

Hydrogels are recognized as the standard treatment for necrotic or sloughy wounds. Autolytic debridement of devitalized tissue is essential to promote wound healing; this depends on the whole area being kept moist so that natural enzymatic reactions can take place. Hydrogels are considered to be gentle debriders, promoting rehydration of non-viable tissues. Hydrosorb and Hydrosorb Comfort are hydrocellular gel dressings that are made from 60% water and are therefore suitable for keeping granulation tissue and young epithelium moist. Additionally, Hydrosorb provides a cushioning effect for wound protection, and has a soothing and cooling effect on superficial burns. For some patients with burns, such as the elderly, Hydrosorb can be applied to speed up the process of debridement where surgery is not an option; a case study is given to show the effective healing process.

ObjectiveTo evaluate health outcomes, resource use and corresponding costs attributable to managing burns in clinical practice, from initial presentation, among a cohort of adults in the UK.DesignRetrospective cohort analysis of the records of a randomly selected cohort of 260 patients from The Health Improvement Network (THIN) database who had 294 evaluable burns.SettingPrimary and secondary care sectors in the UK.Primary and secondary outcome measuresPatients’ characteristics, wound-related health outcomes, healthcare resource use and total National Health Service (NHS) cost of patient management.ResultsDiagnosis was incomplete in 63% of patients’ records as the location, depth and size of the burns were missing. Overall, 70% of all the burns healed within 24 months and the time to healing was a mean of 7.8 months per burn. Sixty-six per cent of burns were initially managed in the community and the other 34% were managed at accident and emergency departments. Patients’ wounds were subsequently managed predominantly by practice nurses and hospital outpatient clinics. Forty-five per cent of burns had no documented dressings in the patients’ records. The mean NHS cost of wound care in clinical practice over 24 months from initial presentation was an estimated £16 924 per burn, ranging from £12 002 to £40 577 for a healed and unhealed wound, respectively.ConclusionsDue to incomplete documentation in the patients’ records, it is difficult to say whether the time to healing was excessive or what other confounding factors may have contributed to the delayed healing. This study indicates the need for education of general practice clinicians on the management and care of burn wounds. Furthermore, it is beholden on the burns community to determine how the poor healing rates can be improved. Strategies are required to improve documentation in patients’ records, integration of care between different providers, wound healing rates and reducing infection.

The aim of wound management in hand burn injuries is to restore function and prevent problem scars, so a key consideration in wound healing is the removal of dressings without causing pain and further trauma as well as preserving function. Conventionally, wound dressings such as paraffin gauze were used for burn injuries, but this led to pain and trauma on removal, as well as drying out. This study looks at the use of Mepitel® One on hand burns; this dressing incorporates all the benefits of Mepitel, however, it only has Safetac technology on the wound contact side, allowing easy handling and application.

The management of biofilms with maintenance desloughing and antimicrobial therapy is fast becoming the accepted treatment strategy for chronic wounds.