Hand burn management: minimising pain and trauma at dressing change

Edwards, Jacky; Mason, Sally

doi:10.12968/bjon.2013.22.sup15.s46

Cited by 6 publications

(8 citation statements)

References 15 publications

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“…This allows movement, protects the burnt skin from contamination, facilitates visual assessment of the skin, and minimizes the frequency of dressings. However, edema and maceration often occur, and patients occasionally find these unsightly 128 . Gore-tex bags are semipermeable, reusable, and theoretically provide a superior healing environment to polythene, with less maceration.…”

Section: Resultsmentioning

confidence: 99%

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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Section: Resultsmentioning

confidence: 99%

Acute Management of Thermal Hand Burns in Adults

et al. 2021

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“…6 , 7 Pain control was presented as a challenge for surgeons, especially for pain-related dressing change. 8 Moreover, another important challenge is coexisting anxiety, which is particularly obvious during the first dressing change. 9 It has been reported that anticipation of pain exacerbates patient anxiety, which in turn can exacerbate the pain.…”

Section: Introductionmentioning

confidence: 99%

Virtual reality distraction, a novel tool for pain alleviation during dressing change following surgical drainage of perianal abscess at Day Treatment Centre

Zheng

Liu

2023

DIGITAL HEALTH

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Background The pain induced by postoperative dressing changes adversely influence recovery and quality of life. In this study, we try to evaluate the pain alleviation effect of virtual reality (VR) distraction during postoperative dressing changes of patients who received surgical drainage of perianal abscess. Methods This was a prospective, randomized clinical trial. A total of 172 patients with perianal abscess were randomly assigned into control (only analgesics) and VR groups (VR distraction + analgesics). The pain and physiological measurements of all patients were collected before, during, and after the first dressing change following surgery. The difference in pain intensity and physiological parameters measurement between control and VR group was analyzed. Results The baseline characteristics of VR and control group were comparable (all P > 0.05). There was no significant difference in mean pain scores prior to and after dressing change between groups (both P > 0.05). Mean pain scores of 5, 10, 15, and 20 min measuring points during the first dressing change were significantly lower in the VR group compared with the control group (all P < 0.05). Pulse rates and oxygen saturation were not significantly different between groups. Conclusion VR can be used as an effective adjuvant pain distraction approach for postoperative dressing change.

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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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Hand burn management: minimising pain and trauma at dressing change

Cited by 6 publications

References 15 publications

Acute Management of Thermal Hand Burns in Adults

Acute Management of Thermal Hand Burns in Adults

Virtual reality distraction, a novel tool for pain alleviation during dressing change following surgical drainage of perianal abscess at Day Treatment Centre

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

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