Duration of cooling with water for thermal burns as a first aid intervention: A systematic review
Autor: | Matthew J. Douma, David Kloeck, Therese Djärv, Eunice M. Singletary, David Zideman, David C. Berry, Jason C Bendall, Laurie J. Morrison, D. Meyran, Tina L Palmieri |
---|---|
Rok vydání: | 2022 |
Předmět: |
Adult
medicine.medical_specialty business.industry MEDLINE Water Skin Transplantation General Medicine Critical Care and Intensive Care Medicine Thermal burn Systematic review Intervention (counseling) Active cooling Emergency Medicine Physical therapy First Aid Humans Medicine Surgery Observational study Duration (project management) Burns Child business First aid |
Zdroj: | Burns. 48:251-262 |
ISSN: | 0305-4179 |
Popis: | Background Cooling thermal burns with running water is a recommended first aid intervention. However, guidance on the ideal duration of cooling remains controversial and inconsistent across organisations. Aim To perform a systematic review of the evidence for the question; Among adults and children with thermal burn, does active cooling using running water as an immediate first aid intervention for 20 minutes or more, compared with active cooling using running water for any other duration, change the outcomes of burn size, burn depth, pain, adverse outcome (hypothermia) or complications? Method We searched Medline, Embase, Cochrane Database of Systematic Reviews and used ROBINS-I to assess for risk of bias. We used Grading of Recommendations, Assessment, Development and Evaluation methodology for determining the certainty of evidence. We included all studies that compared the selected outcomes of the duration of cooling of thermal burns with water in all patient ages. (PROSPERO registration number: CRD42021180665). From 560 screened references, we included four observational studies. In these studies, 48% of burns were cooled for 20 minutes or more. We found no benefit for a duration of 20 minutes or more of cooling when compared with less than 20 minutes of cooling for the outcomes of size and depth of burn, re-epithelialization, or the need for skin grafting. The evidence is of very low certainty owing to limitations in study design, risk of bias and indirectness. Conclusion The optimal duration of cooling for thermal burns remains unknown and future prospective research is required to better define this treatment recommendation. |
Databáze: | OpenAIRE |
Externí odkaz: |