Efficacy of debridement and wound cleansing with 2% hydrogen peroxide on graft take in the chronic-colonized burn wounds; a randomized controlled clinical trial

Mohammadi, Ali Akbar; Jafari, S. Morteza Seyed; Kiasat, Mandana; Pakyari, Mohammad Reza; Ahrari, Iman

doi:10.1016/j.burns.2013.01.019

Cited by 32 publications

(20 citation statements)

References 23 publications

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“…39 In contrast, a significant better graft take (82, 85% vs 65, 61%) in chronic-colonized burn wounds could be shown in an intra-individual comparison (n ¼ 49) after wound cleansing with 2% hydrogen peroxide compared with conventional debridement with curetting and lavage with saline (LoE 3). 40 Several case reports describe miscellaneous topics such as topical anesthesia for wound debridement, 41 larvae therapy to debride full-thickness or infected burn wound, [42][43][44] burn wound debridement via erbium: YAG laser, 45 the equipment of a cautery knife with an air spray to maintain better sight on bleeding wound areas, 46 or wound dyeing with methylene blue to facilitate adequate debridement 47 (LoE 4 or lower).…”

Section: Miscellaneous Debridement Methodsmentioning

confidence: 99%

Evidence and Trends in Burn Wound Debridement: An Evidence Map

et al. 2020

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Treatment of the burn wound is crucial in care of severely burned patients. Surgical strategies differ in technique and timing of wound excision and are considered to have an impact on morbidity and mortality of burn patients. Most techniques and strategies have been established during the last century and are still standard of care. Nonetheless, several newer techniques have been presented and evaluated recently. To summarize the evidence and trends for eschar removal by burn wound debridement currently available, an evidence map as variant of the systematic review, was prepared. For this purpose, a systematic literature search was performed in the PubMed databases until December 2016. While overall evidence in this domain is low, recent publications focus on optimal timing of wound excision, enzymatic debridement, and hydrosurgery. Several studies report the benefit of an early wound excision in terms of shorter hospital stay, lower wound infection rate, and reduction of postburn metabolic changes. Enzymatic debridement has been shown to be an effective tool for early eschar removal and in addition reduces the need for autografting of the debrided burn wound with a relatively high level of evidence (LoE 2-). Wound debridement by means of hydrosurgery is more precise compared to conventional wound excision and preserves viable dermis, but a positive effect on wound healing or scar formation could not been shown (LoE 2). Furthermore, rarely reported techniques comprise larvae therapy, debridement by laser, and other technical adjuncts, but the level of evidence is limited (LoE 4-/5).

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Section: Miscellaneous Debridement Methodsmentioning

confidence: 99%

Evidence and Trends in Burn Wound Debridement: An Evidence Map

et al. 2020

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“…It is also an adjunct hemostatic to topical epinephrine in patients with known platelet dysfunction after burn excision [58] . Equally important, it has an inherent risk of fatal oxygen embolism formation [59,60] on chronic-colonized burn wounds for 5 min followed by normal saline irrigation and grafting elevated the success rate of graft take when compared with the conventional method of debridement and skin grafting [63] .…”

Section: Current Clinical Use Of Hydrogen Peroxidementioning

confidence: 99%

Hydrogen Peroxide: A Potential Wound Therapeutic Target

Zhu¹,

Wang²,

Lu³

et al. 2017

Med Princ Pract

115

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Hydrogen peroxide (H2O2) is a topical antiseptic used in wound cleaning which kills pathogens through oxidation burst and local oxygen production. H2O2 has been reported to be a reactive biochemical molecule synthesized by various cells that influences biological behavior through multiple mechanisms: alterations of membrane potential, generation of new molecules, and changing intracellular redox balance, which results in activation or inactivation of different signaling transduction pathways. Contrary to the traditional viewpoint that H2O2 probably impairs tissue through its high oxidative property, a proper level of H2O2 is considered an important requirement for normal wound healing. Although the present clinical use of H2O2 is still limited to the elimination of microbial contamination and sometimes hemostasis, better understanding towards the sterilization ability and cell behavior regulatory function of H2O2 within wounds will enhance the potential to exogenously augment and manipulate healing.

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“…Conversely, in plastic surgery multiple studies have shown benefit of hydrogen peroxide on chronic wounds. Mohammadi et al in a randomized clinical trial of chronic colonized burn wounds showed that 2% hydrogen peroxide wound cleansing significantly improved skin graft take rates 41. Another trial by Irkoren demonstrated that hydrosurgery with hydrogen peroxide was superior to controls without hydrogen peroxide for infected wounds, resulting in shorter hospital stay and enhanced graft viability 42.…”

Section: Clinical Resultsmentioning

confidence: 99%

Hydrogen Peroxide Wound Irrigation in Orthopaedic Surgery

Lü

Hansen

2017

J. Bone Joint Infect.

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As the burden of deep hardware infections continues to rise in orthopaedics, there is increasing interest in strategies for more effective debridement of colonized tissues and biofilm. Hydrogen peroxide has been used medically for almost a century, but its applications in orthopaedic surgery have yet to be fully determined. The basic science and clinical research on the antiseptic efficacy of hydrogen peroxide have demonstrated its efficacy against bacteria, and it has demonstrated potential synergy with other irrigation solutions such as chlorhexidine and povidone-iodine. While hydrogen peroxide is effective in infection reduction, there are concerns with wound healing, cytotoxicity, and embolic phenomena, and we recommend against hydrogen peroxide usage in the treatment of partial knee replacements, hemiarthroplasties, or native joints. Additionally, due to the potential for oxygen gas formation, hydrogen peroxide should not be used in cases of dural compromise, when pressurizing medullary canals, or when irrigating smaller closed spaces to avoid the possibility of air embolism. Finally, we present our protocol for irrigation and debridement and exchange of modular components in total joint arthroplasty, incorporating hydrogen peroxide in combination with povidone-iodine and chlorhexidine.

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Efficacy of debridement and wound cleansing with 2% hydrogen peroxide on graft take in the chronic-colonized burn wounds; a randomized controlled clinical trial

Cited by 32 publications

References 23 publications

Evidence and Trends in Burn Wound Debridement: An Evidence Map

Evidence and Trends in Burn Wound Debridement: An Evidence Map

Hydrogen Peroxide: A Potential Wound Therapeutic Target

Hydrogen Peroxide Wound Irrigation in Orthopaedic Surgery

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