Hand burn management: minimising pain and trauma at dressing change

Edwards, Jacky; Mason, Sally

doi:10.12968/bjon.2013.22.sup20.s46

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…Dressing the hand with appropriate wound covers should minimise the level of pain, prevent the formation of scar contractures and guarantee the largest possible functionality. Conventional wound dressings such as paraffin gauze do not meet the above criteria for the treatment . It is believed that skin grafting of partial‐thickness wounds offer positive clinical effects in 97% of patients with superficial wounds of the hands and in 81% of patients with deep wounds.…”

Section: Introductionmentioning

confidence: 99%

A new option for definitive burn wound closure – pair matching type of retrospective case–control study of hand burns in the hospitalised patients group in the Dr Stanislaw Sakiel Centre for Burn Treatment between 2009 and 2015

Glik

Kawecki

Kitala

et al. 2017

International Wound Journal

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Nearly 80% of all burns include the hands of affected individuals. Skin grafting is the gold standard in burns treatment, but in the case of the burn wound bed, it may require the necessity of utilising skin substitutes to facilitate closure. The aim of this study is to assess the impact of a porcine-derived wound dressing (Oasis™) for application to hand burns compared to a synthetic dressing (Suprathel™). Comparative assessments were made, including the time to heal, quality of healing and pain intensity. A retrospective, unblinded, matching pair case-control of hand burns was performed. A control group of 24 patients was treated with Suprathel dressing, and a study group of six patients underwent application of the Oasis dressing. The wound healing process was evaluated by taking histopathological specimens and also utilising the Bates-Jensen Wound Assessment Tool. A 10-cm Visual Analogue Scale (VAS) was used for pain assessment. Other parameters measured included dressing loss because of infection and the need of rehabilitation. The progress of wound healing on the fourth day in the study group was 30%. A decrease in the level of pain was recorded on the fourth day after surgery. There was a decrease of 5% in the risk of rehabilitation in the treatment group.

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Section: Introductionmentioning

confidence: 99%

A new option for definitive burn wound closure – pair matching type of retrospective case–control study of hand burns in the hospitalised patients group in the Dr Stanislaw Sakiel Centre for Burn Treatment between 2009 and 2015

Glik

Kawecki

Kitala

et al. 2017

International Wound Journal

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“…WCL dressings are also expected to limit peri‐wound skin damage and, while not designed to absorb and retain moderate to strong exudation, it was designed to favour drainage of excessive wound fluids towards secondary absorbent dressings . In addition, WCL dressing changes should be atraumatic to viable tissue and as painless as possible …”

Section: Introductionmentioning

confidence: 99%

A randomised, controlled, non‐inferiority trial comparing the performance of a soft silicone‐coated wound contact layer (Mepitel One) with a lipidocolloid wound contact layer (UrgoTul) in the treatment of acute wounds

David¹,

Wurtz²,

Breton

et al. 2017

International Wound Journal

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Wound contact layer (WCL) dressings are intended to protect tissue during the healing process. A randomised controlled trial was undertaken to compare 2 such dressings. Outpatients with acute wounds were randomly allocated to treatment with either a soft silicone‐coated WCL (intervention group, n = 59) or a lipidocolloid‐impregnated WCL (control group, n = 62). At the first dressing removal (day 3), 89.8% of patients in the intervention group experienced non‐painful dressing removal (defined as a pain rating <30 mm on a 100 mm visual analogue scale), compared with 73.6% of patients in the control group (P = .017) (per protocol population). At day 21, wounds were considered as healed in 66.1% of patients in the intervention group compared with 43.5% in the control group (P = .012) (intention‐to‐treat population). Both dressings were well tolerated and rated highly in terms of in‐use characteristics, although the soft silicone‐coated WCL was rated significantly higher than the lipidocolloid‐impregnated WCL in terms of its ability to remain in place (P= .016). The results indicate that the soft silicone‐coated WCL is suitable for the management of acute wounds as it can minimise dressing‐associated pain and support healing.

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Acute Management of Thermal Hand Burns in Adults

et al. 2021

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Introduction Advances in the evidence base of acute thermal hand burns help to guide the management of these common injuries. The aim of this literature review was to evaluate recent evidence in the field over 10 years. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols methodology was used as a guide for this literature review. PubMed, MEDLINE, EMBASE, CINAHL, and Google Scholar were searched for English language articles related to hand burns published between 2009 and 2018 inclusive, and the Cochrane Library was reviewed. Exclusion criteria were as follows: participants younger than 18 years, scar or contracture management, rehabilitation, outcomes assessment, late reconstruction, and electrical or chemical burns. Results An initial search retrieved 6493 articles, which was narrowed to 403 full-text articles that were reviewed independently by 3 of the authors and categorized. Of 202 included articles, there were 8 randomized controlled trials and 2 systematic reviews. Six evidence-based guidelines were reviewed. Referral of hand burns to specialist centers, use of telemedicine, early excision and grafting, and immediate static splintage have been recommended. Enzymatic debridement results in earlier intervention, more accurate burn assessment, preservation of vital tissue, and fewer skin grafts, and ideally requires regional anesthesia. Guidance on escharotomy emphasizes indication, technique and adequate intervention, and potential for enzymatic debridement. Inclusion of topical negative pressure, dermal regenerative templates, acellular dermal matrices, and noncellular skin substitutes in management has helped improve scar and functional outcomes. Discussion The results of this literature review demonstrate that multiple national and international societies have published burns guidelines during the decade studied, with aspects directly relevant to hand burns, including the International Society for Burn Injuries guidelines. There are opportunities for evidence-based quality improvement across the field of hand burns in many centers. Conclusions More than 200 articles globally in 10 years outline advances in the understanding of acute management of thermal hand burns. Incorporating the evidence base into practice may facilitate optimization of triage referral pathways and acute management for hand burns.

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Hand burn management: minimising pain and trauma at dressing change

Cited by 5 publications

References 15 publications

A new option for definitive burn wound closure – pair matching type of retrospective case–control study of hand burns in the hospitalised patients group in the Dr Stanislaw Sakiel Centre for Burn Treatment between 2009 and 2015

A new option for definitive burn wound closure – pair matching type of retrospective case–control study of hand burns in the hospitalised patients group in the Dr Stanislaw Sakiel Centre for Burn Treatment between 2009 and 2015

A randomised, controlled, non‐inferiority trial comparing the performance of a soft silicone‐coated wound contact layer (Mepitel One) with a lipidocolloid wound contact layer (UrgoTul) in the treatment of acute wounds

Acute Management of Thermal Hand Burns in Adults

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