Play and heal: Randomized controlled trial of Ditto™ intervention efficacy on improving re-epithelialization in pediatric burns

Brown, Nadia J.; Kimble, Roy M.; Rodger, Sylvia; Ware, Robert S.; Cuttle, Leila

doi:10.1016/j.burns.2013.11.024

Cited by 111 publications

(159 citation statements)

References 55 publications

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“…procedures are associated with delays in wound re-epithelialization [45,47]. The reduced levels of pain associated with Acticoat™ with Mepitel™ and Mepilex Ag™ in this study, in conjunction with significantly faster re-epithelialization in the Mepilex Ag™ group has provided evidence to strongly consider the utilization of dressings with added-on or in-built silicone interfaces to manage acute burn injuries in the pediatric population.…”

Section: Discussionmentioning

confidence: 80%

“…face). Higher levels of pain and distress during wound care procedures in children have been found to be associated with delays in wound reepithelialization [45]. Thus the use of wound measurement methods that involve direct wound contact or take a prolonged amount of time, such as the Visitrak™ system, should be re-considered for all children, especially those under the age of three years.…”

Section: Discussionmentioning

confidence: 99%

“…It is proposed to adhere to normal, intact skin remaining in situ on the surface of a wound but not adhere to the wound bed, maintaining a moist wound environment while providing a less traumatic and painful removal and subsequently less epidermal damage [8,61]. This technology may be of great use in the pediatric burn population, where pain during dressing change procedures has been found to be detrimental to the child in terms wound of re-epithelialization [45][46][47]62]. Acticoat TM silver dressing can be used in conjunction with non-stick interface dressings such as Mepitel TM (Mölnlycke Healthcare, Mikkeli, Finland) or on its own.…”

Section: Silicone Interface Dressingsmentioning

confidence: 99%

“…These changes in the inflammatory phase can, as a result, delay processes in the proliferation phase of wound re-epithelialization where the recruitment and replication of cells required for tissue generation and capillary growth occurs. In turn, the entire re-epithelialization process can become delayed [45,46,52].…”

Section: B Amentioning

confidence: 99%

“…Factors such as infection, wound dressing application, and removal and pain can all affect re-epithelialization rates of the wound and all must be considered during wound treatment decision-making [45,46].…”

Section: Outpatient Management Of Pediatric Partial Thickness Burnsmentioning

confidence: 99%

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A holistic exploration of paediatric partial thickness burn care in the outpatient setting

Kee¹

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Silicone Interface Dressingsmentioning

confidence: 99%

Section: B Amentioning

confidence: 99%

Section: Outpatient Management Of Pediatric Partial Thickness Burnsmentioning

confidence: 99%

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A holistic exploration of paediatric partial thickness burn care in the outpatient setting

Kee¹

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Effects of an Immersive Virtual Reality Intervention on Pain and Anxiety Among Pediatric Patients Undergoing Venipuncture

Wong

Choi

2023

JAMA Netw Open

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ImportanceVenipuncture is one of the most painful and distressing procedures experienced by pediatric patients. Emerging evidence suggests that providing procedural information and distraction using immersive virtual reality (IVR) may reduce pain and anxiety among children undergoing needle-related procedures.ObjectivesTo examine the effects of IVR on reducing the pain, anxiety, and stress experienced by pediatric patients undergoing venipuncture.Design, Setting, and ParticipantsThis 2-group randomized clinical trial recruited pediatric patients aged 4 to 12 years undergoing venipuncture from a public hospital in Hong Kong between January 2019 and January 2020. Data were analyzed from March to May 2022.InterventionsParticipants were randomly allocated to an intervention (an age-appropriate IVR intervention offering distraction and procedural information) or a control (standard care only) group.Main Outcomes and MeasuresThe primary outcome was child-reported pain. Secondary outcomes included child-reported anxiety, heart rate, salivary cortisol, length of procedure, and satisfaction of health care professionals with the procedure (rated on a 40 point scale, with higher scores indicating greater satisfaction). Outcomes were assessed 10 minutes before, during, immediately after, and 30 minutes after the procedure.ResultsA total of 149 pediatric patients were recruited, with 86 female patients (57.7%) and 66 patients (44.3%) diagnosed with fever. Compared with the 74 participants in the control group (mean [SD] age, 7.21 [2.49] years), the 75 participants in the IVR group (mean [SD] age, 7.21 [2.43] years) reported significantly less pain (β = −0.78; 95% CI, −1.21 to −0.35; P &lt; .001) and anxiety (β = −0.41; 95% CI, −0.76 to −0.05; P = .03) immediately after the intervention. Health care professional satisfaction in the IVR group (mean [SD] score, 34.5 [4.5]) was significantly higher than that in the control group (mean [SD] score, 32.9 [4.0]; P = .03). Moreover, the length of venipuncture procedure in the IVR group (mean [SD] duration, 4.43 [3.47] minutes) was significantly shorter than that in the control group (mean [SD] duration, 6.56 [7.39] minutes; P = .03).Conclusions and RelevanceIn this randomized clinical trial, integrating procedural information and distraction in an IVR intervention for pediatric patients undergoing venipuncture significantly improved pain and anxiety in the IVR group compared with the control group. The results shed light on the global trends of research on IVR and its clinical development as an intervention for other painful and stressful medical procedures.Trial RegistrationChinese Clinical Trial Registry identifier: ChiCTR1800018817

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Virtual reality distraction for acute pain in children

Lambert

Boylan

Boran

et al. 2020

Cochrane Database of Systematic Reviews

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BackgroundVirtual reality (VR) computer technology creates a simulated environment, perceived as comparable to the real world, with which users can actively interact. The e ectiveness of VR distraction on acute pain intensity in children is uncertain. ObjectivesTo assess the e ectiveness and adverse e ects of virtual reality (VR) distraction interventions for children (0 to 18 years) with acute pain in any healthcare setting. Search methodsWe searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO and four trial registries to October 2019. We also searched reference lists of eligible studies, handsearched relevant journals and contacted study authors. Selection criteriaRandomised controlled trials (RCTs), including cross-over and cluster-RCTs, comparing VR distraction to no distraction, non-VR distraction or other VR distraction. Data collection and analysisWe used standard Cochrane methodological processes. Two reviewers assessed risk of bias and extracted data independently. The primary outcome was acute pain intensity (during procedure, and up to one hour post-procedure). Secondary outcomes were adverse e ects, child satisfaction with VR, pain-related distress, parent anxiety, rescue analgesia and cost. We used GRADE and created 'Summary of findings' tables. Main resultsWe included 17 RCTs (1008 participants aged four to 18 years) undergoing various procedures in healthcare settings. We did not pool data because the heterogeneity in population (i.e. diverse ages and developmental stages of children and their di erent perceptions and reactions to pain) and variations in procedural conditions (e.g. phlebotomy, burn wound dressings, physical therapy sessions), and consequent level of pain experienced, made statistical pooling of data impossible. We narratively describe results.We judged most studies to be at unclear risk of selection bias, high risk of performance and detection bias, and high risk of bias for small sample sizes. Across all comparisons and outcomes, we downgraded the certainty of evidence to low or very low due to serious study limitations and serious or very serious indirectness. We also downgraded some of the evidence for very serious imprecision. Virtual reality distraction for acute pain in children (Review)

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Play and heal: Randomized controlled trial of Ditto™ intervention efficacy on improving re-epithelialization in pediatric burns

Cited by 111 publications

References 55 publications

A holistic exploration of paediatric partial thickness burn care in the outpatient setting

A holistic exploration of paediatric partial thickness burn care in the outpatient setting

Effects of an Immersive Virtual Reality Intervention on Pain and Anxiety Among Pediatric Patients Undergoing Venipuncture

Virtual reality distraction for acute pain in children

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