The efficacy of cellulose dressings in burn wound management: a systematic review and meta-analysis

Tristan Hill; Abdal Qadir Zafar; Tal D Ellenbogen; Neil C Mathias; Neil D Muscat; Dimitrios Papakonstantinou; Rokhan Yousaf Zai; Asad Maqbool; Shafiq Rahman

doi:10.1016/j.burns.2024.107318

The efficacy of cellulose dressings in burn wound management: a systematic review and meta-analysis

Burns. 2024 Nov 13;51(1):107318. doi: 10.1016/j.burns.2024.107318. Online ahead of print.

Authors

Tristan Hill¹, Abdal Qadir Zafar², Tal D Ellenbogen³, Neil C Mathias⁴, Neil D Muscat⁵, Dimitrios Papakonstantinou⁶, Rokhan Yousaf Zai⁷, Asad Maqbool⁸, Shafiq Rahman⁸

Affiliations

¹ Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust, UK; Plastic, Reconstructive and Burns Surgery, Mid Yorkshire Hospitals Teaching Trust. Electronic address: [email protected].
² Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust, UK; Orthopaedics, Royal London Hospital, Bart's NHS Trust.
³ Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust, UK; Trauma & Orthopaedic Surgery, Nottingham University Hospitals NHS Trust.
⁴ Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust, UK; General Surgery, Nottingham University Hospitals NHS Trust.
⁵ Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust, UK; General Surgery, Bolton Foundation Trust.
⁶ Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust, UK; Plastic, Reconstructive and Burns Surgery, Mid Yorkshire Hospitals Teaching Trust.
⁷ Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust, UK; Division of Surgery and Interventional Sciences, University College London.
⁸ Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust, UK.

PMID: 39721087
DOI: 10.1016/j.burns.2024.107318

Abstract

Introduction: Burn wound management is challenging, especially in paediatric patients when optimising outcomes. Superficial burns are generally managed conservatively with dressings; however, frequent dressing changes can be a source of pain and discomfort. Cellulose dressings mitigate these problems, and current reports in the literature have demonstrated positive outcomes when compared against routine dressing types. The authors aim to report a systematic review and meta-analysis on the use of cellulose-based dressings in burn wound management.

Methods: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement standards. The primary outcome measures were epithelialisation rate, duration of hospital stay, and the number of dressing changes. The electronic databases of MEDLINE, EMBASE, CINAHL, Google Scholar, PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched. OpenMeta [analyst] software was used for data synthesis.

Results: Eleven studies were included in the qualitative synthesis with eight articles meeting the inclusion criteria for quantitative analysis, with cellulose-based dressings showing a significantly increased rate of healing on mean difference analysis: 1.350 (0.007, 2.694), standard error; 0.685, p = 0.049. A shorter duration of hospital stay was also observed in the cellulose cohort: 6.583 (5.739, 7.428), standard error 0.431, p < 0.001. Likewise the frequency of dressing changes was lower: odds ratio 0.125 (0.015, 1.062), p < 0.001. There was no difference in the infection rate compared to standard dressings.

Conclusion: Cellulose dressings can expedite wound healing whilst reducing the duration of hospitalisation and frequency of dressing changes compared to standard dressings in burn wound management. The authors however recommend further high quality trials to enhance the current evidence base.

Keywords: Burns; Burns Wound Management; Cellulose-based dressings; Epiprotect.