The efficacy of hydrogel dressings as a first aid measure for burn wound management in the pre‐hospital setting: a systematic review of the literature

Abstract

The aim of this systematic review was to determine the supporting evidence for the clinical use of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting. Two authors searched three databases (Ovid Medline, Ovid Embase and The Cochrane Library) for relevant English language articles published through September 2014. Reference lists, conference proceedings and non-indexed academic journals were manually searched. A separate search was conducted using the Internet search engine Google to source additional studies from burns advisory agencies, first aid bodies, military institutions, manufacturer and paramedic websites. Two authors independently assessed study eligibility and relevance of non-traditional data forms for inclusion. Studies were independently assessed and included if Hydrogel-based burn dressings (HBD) were examined in first aid practices in the pre-hospital setting. A total of 129 studies were considered for inclusion, of which no pre-hospital studies were identified. The review highlights that current use of HBD in the pre-hospital setting appears to be driven by sources of information that do not reflect the paramedic environment. We recommend researchers in the pre-hospital settings undertake clinical trials in this field. More so, the review supports the need for expert consensus to identify key demographic, clinical and injury outcomes for clinicians and researchers undertaking further research into the use of dressings as a first aid measure.

Poor methodological quality and reporting standards of systematic reviews in burn care management

“…Of those, we excluded an additional 59 studies because they failed to meet the methodological definition of systematic review as per our inclusion criteria . Therefore, a total of 60 systematic reviews formed the basis of this study …”

Selection of Appropriate Wound Dressing for Various Wounds

“…Hydrogels have a three-dimensional structure composed of hydrophilic substances (Tsang and Bhatia, 2004). They are insoluble in water and subsequently absorb water from 10% to thousands fold their equivalent weight (Goodwin et al, 2016). Owing to their excellent moisturizing ability, hydrogels maintain the wound moist and play a positive role in the cleansing of necrotic tissue.…”

Synthesis and Applications of Protein/Peptide-Polymer Conjugates

“…Open wounds such as those presented by severe burns, are particularly susceptible to ‘superbug’ infections due to the disruption of the epidermal barrier, the systemic apoptotic response and immunosuppression that disrupts self‐defense mechanisms to fight infection . Therefore, the use of topical antimicrobial chemotherapy has been fundamental and helped to improve the management and survival of patients with major burns by minimising the incidence of life‐threatening burn wound sepsis …”

“…[118] Therefore, the use of topical antimicrobial chemotherapy has been fundamental and helped to improve the management and survival of patients with major burns by minimising the incidence of life-threatening burn wound sepsis. [119] Polymyxins B and Polymyxin E (colistin) [120] are administered clinically for treatment of MDR gramnegative bacterial infections. The lipopeptide can bind to lipopolysaccharide (LPS) in the bacterial outer membrane, altering the permeability leading to cell death.…”