The Comparison of Non-Silver-Based Treatment vs Silver-Based Treatment in Pediatric Burns: Meta-Analysis and Systematic Review
DOI:
https://doi.org/10.71341/bmwj.v1i2.14Keywords:
silver, burn, pediatric, meta-analysisAbstract
Background: Pediatric burn injuries are a significant global concern, caused by factors such as child maltreatment, fire accidents, and scalding. Effective treatment aims to enhance wound healing and re-epithelialization. Silver-based treatments are a standard approach for burn wounds, but new alternatives may offer improved outcomes.
Objective: This study conducts a meta-analysis and systematic review to compare silver and non-silver treatments in pediatric burn care.
Methods: A comprehensive literature review and meta-analysis were conducted using the PRISMA guidelines. Data from PubMed, Cochrane Library, and ScienceDirect were utilized. The study focused on children with burn injuries, comparing non-silver treatments (intervention) against silver treatments (control) and assessing outcomes like wound healing, dressing frequency, hospital stay length, complications, graft needs, and pain.
Results: The review included 12 randomized controlled trials with 719 participants. Silver treatments served as controls against various non-silver options. Although many trials showed bias and varied quality, results indicated that non-silver treatments led to faster wound healing (mean difference: -0.86 days; 95% CI: −1.26, −0.46; p < 0.0001), fewer dressing changes (mean difference: -2.07 times; 95% CI: -3.39, -0.75; p = 0.0002), and reduced hospital stays (mean difference: −0.76 days; 95% CI: −1.57, 0.05; p = 0.07). No significant differences were found in infection rates or graft needs.
Conclusion: Non-silver treatments in pediatric burns result in faster healing, fewer dressings, and shorter hospital stays compared to silver treatments. Further large-scale studies are necessary to confirm these findings.
References
Barret, J.P., Dziewulski, P., Ramzy, P.I., Wolf, S.E., Desai, M.H. & Herndon, D.N. 2000, ‘Biobrane versus 1% Silver Sulfadiazine in Second-Degree Pediatric Burns’, Plastic and Reconstructive Surgery, vol. 105, no. 1, pp. 62–5.
Bugmann, P., Taylor, S., Gyger, D., Lironi, A., Genin, B., Vunda, A., La Scala, G., Birraux, J. & Le Coultre, C. 1998, ‘A silicone-coated nylon dressing reduces healing time in burned paediatric patients in comparison with standard sulfadiazine treatment: a prospective randomized trial’, Burns, vol. 24, no. 7, pp. 609–12.
Cartotto, R. 2017, ‘Topical antimicrobial agents for pediatric burns’, Burns & Trauma, vol. 5.
Choi, Y.M., Campbell, K., Levek, C., Recicar, J. & Moulton, S. 2019, ‘Antibiotic ointment versus a silver-based dressing for children with extremity burns: A randomized controlled study’, Journal of Pediatric Surgery, vol. 54, no. 7, pp. 1391–6.
Elliott, C. 2010, ‘The effects of silver dressings on chronic and burns wound healing’, British Journal of Nursing, vol. 19, no. Sup5, pp. S32–6.
Eskandarlou, M., Azimi, M., Rabiee, S. & Seif Rabiee, M.A. 2016, ‘The Healing Effect of Amniotic Membrane in Burn Patients.’, World journal of plastic surgery, vol. 5, no. 1, pp. 39–44.
Fan, C., Pek, C., Por, Y. & Lim, G. 2018, ‘Biobrane dressing for paediatric burns in Singapore: a retrospective review’, Singapore Medical Journal, vol. 59, no. 7, pp. 360–5.
Gotschall, C.S., Morrison, M.I.S. & Eichelberger, M.R. 1998, ‘Prospective, Randomized Study of the Efficacy of Mepitel*on Children With Partial-Thickness Scalds’, Journal of Burn Care & Rehabilitation, vol. 19, no. 4, pp. 279–83.
Gupta, S., Kumar, N. & Tiwari, V. 2017, ‘Silver sulfadiazine versus sustained-release silver dressings in the treatment of burns: A surprising result’, Indian Journal of Burns, vol. 25, no. 1, p. 38.
Karlsson, M., Elmasry, M., Steinvall, I., Sjöberg, F., Olofsson, P. & Thorfinn, J. 2019, ‘Superiority of silver-foam over porcine xenograft dressings for treatment of scalds in children: A prospective randomised controlled trial’, Burns, vol. 45, no. 6, pp. 1401–9.
Karlsson, M., Steinvall, I., Sjöberg, F., Olofsson, P. & Elmasry, M. 2020, ‘Burn scar outcome at six and 12 months after injury in children with partial thickness scalds: Effects of dressing treatment’, Burns, vol. 46, no. 3, pp. 546–51.
Krishnamoorthy, V., Ramaiah, R. & Bhananker, S. 2012, ‘Pediatric burn injuries’, International Journal of Critical Illness and Injury Science, vol. 2, no. 3, p. 128.
Kumar, R.J., Kimble, R.M., Boots, R. & Pegg, S.P. 2004, ‘Treatment of partial‐thickness burns: a prospective, randomized trial using Transcyte TM’, ANZ Journal of Surgery, vol. 74, no. 8, pp. 622–6.
Lal, S., Barrow, R.E., Wolf, S.E., Chinkes, D.L., Hart, D.W., Heggers, J.P. & Herndon, D.N. 2000, ‘BIOBRANE® IMPROVES WOUND HEALING IN BURNED CHILDREN WITHOUT INCREASED RISK OF INFECTION’, Shock, vol. 14, no. 3, pp. 314–9.
Lima Júnior, E.M., Moraes Filho, M.O. de, Forte, A.J., Costa, B.A., Fechine, F.V., Alves, A.P.N.N., Moraes, M.E.A. de, Rocha, M.B.S., Silva Júnior, F.R., Soares, M.F.A. do N., Bezerra, A.N., Martins, C.B. & Mathor, M.B. 2019, ‘Pediatric Burn Treatment Using Tilapia Skin as a Xenograft for Superficial Partial-Thickness Wounds: A Pilot Study’, Journal of Burn Care & Research.
Lin, D., Kao, Y., Chen, C., Wang, H. & Chiu, W. 2021, ‘Negative pressure wound therapy for burn patients: A meta‐analysis and systematic review’, International Wound Journal, vol. 18, no. 1, pp. 112–23.
Mandal, A. 2007, ‘Paediatric partial‐thickness scald burns – is Biobrane the best treatment available?’, International Wound Journal, vol. 4, no. 1, pp. 15–9.
Mathias, E. & Srinivas Murthy, M. 2017, ‘Pediatric Thermal Burns and Treatment: A Review of Progress and Future Prospects’, Medicines, vol. 4, no. 4, p. 91.
Mostaque, A.K. & Rahman, K.B.M.A. 2011, ‘Comparisons of the Effects of Biological Membrane (Amnion) and Silver Sulfadiazine in the Management of Burn Wounds in Children’, Journal of Burn Care & Research, vol. 32, no. 2, pp. 200–9.
Munteanu, A., Florescu, I.P. & Nitescu, C. 2016, ‘A modern method of treatment: The role of silver dressings in promoting healing and preventing pathological scarring in patients with burn wounds.’, Journal of medicine and life, vol. 9, no. 3, pp. 306–15.
National Safety Council 2017, Injury Facts, National Safety Council, Itasca.
Nímia, H.H., Carvalho, V.F., Isaac, C., Souza, F.Á., Gemperli, R. & Paggiaro, A.O. 2019, ‘Comparative study of Silver Sulfadiazine with other materials for healing and infection prevention in burns: A systematic review and meta-analysis’, Burns, vol. 45, no. 2, pp. 282–92.
Oaks, R.J. & Cindass, R. 2024, Silver Sulfadiazine.
Ostlie, D.J., Juang, D., Aguayo, P., Pettiford-Cunningham, J.P., Erkmann, E.A., Rash, D.E., Sharp, S.W., Sharp, R.J. & St. Peter, S.D. 2012, ‘Topical silver sulfadiazine vs collagenase ointment for the treatment of partial thickness burns in children: a prospective randomized trial’, Journal of Pediatric Surgery, vol. 47, no. 6, pp. 1204–7.
Paddock, H., Fabia, R., Giles, S., Hayes, J., Lowell, W. & Besner, G. 2006, ‘A Silver Impregnated Antimicrobial Dressing Reduces Hospital Length of Stay for Pediatric Burn Patients’, Journal of Burn Care & Research, vol. 27, no. Supplement, p. S60.
Smolle, C., Cambiaso-Daniel, J., Forbes, A.A., Wurzer, P., Hundeshagen, G., Branski, L.K., Huss, F. & Kamolz, L.-P. 2017, ‘Recent trends in burn epidemiology worldwide: A systematic review.’, Burns : journal of the International Society for Burn Injuries, vol. 43, no. 2, pp. 249–57.
Suman, A. & Owen, J. 2020, ‘Update on the management of burns in paediatrics’, BJA Education, vol. 20, no. 3, pp. 103–10.
Wood, F., Martin, L., Lewis, D., Rawlins, J., McWilliams, T., Burrows, S. & Rea, S. 2012, ‘A prospective randomised clinical pilot study to compare the effectiveness of Biobrane® synthetic wound dressing, with or without autologous cell suspension, to the local standard treatment regimen in paediatric scald injuries’, Burns, vol. 38, no. 6, pp. 830–9.
World Health Organization 2023, ‘Burns’, https://www.who.int/news-room/fact-sheets/detail/burns.
Wu, J.-J., Zhang, F., Liu, J., Yao, H.-J. & Wang, Y. 2023, ‘Effect of silver-containing hydrofiber dressing on burn wound healing: A meta-analysis and systematic review.’, Journal of cosmetic dermatology, vol. 22, no. 5, pp. 1685–91.
Yang, C., Xiong, A.B., He, X.C., Ding, X. Bin, Tian, X.L., Li, Y. & Yan, H. 2021, ‘Efficacy and feasibility of amniotic membrane for the treatment of burn wounds: A meta-analysis’, Journal of Trauma and Acute Care Surgery, vol. 90, no. 4, pp. 744–55.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Ida Ayu Cempaka Dewi Yatindra, Ratna Rayeni Natasha Rooseno, R.Ratu Kania Tiaraningrum, Made Surya Dharmawan
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
License
This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercial purposes.
- Adaptation — mixing, changing, and developing materials for any purpose, even commercial ones.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
