Wound Treatment - News From The Cochrane Library: Burn Treatment Cream May Delay Healing And Honey Helps To Heal Wounds

Main Category: Dermatology
Article Date: 08 Oct 2008 - 1:00 PDT

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Honey may reduce healing times in patients suffering mild to moderate burn wounds. A systematic review by Cochrane Researchers concluded that honey might be useful as an alternative to traditional wound dressings in treating burns.

Burn Treatment Cream May Delay Healing

A cream commonly used to treat burns may actually delay healing. In addition, despite the wide range of wound dressings available for burns, there is no consensus on the most effective alternative treatment, say Cochrane Researchers who carried out a systematic review of existing data.

Increased understanding of the wound healing process means that there are now a large number of different ways to treat burns. Films, gels, artificial skins and fibre dressings may all help to heal wounds, but doctors still often turn to traditional gauze dressings, as well as silver sulphadiazine (SSD) cream. Healthcare providers have used SSD cream since the 1960s to minimize the risk of burns becoming infected, although concerns have recently been raised about its toxic effects on skin cells.

The Cochrane Team who carried out the research found 26 relevant trials. Although each trial was relatively small they concluded that SSD cream increases the time taken for a wound to heal, as well as increasing the number of dressing applications required.

"We think that the use of SSD cream on burn wounds needs to be reconsidered," says lead researcher, Jason Wasiak, who works for the Victorian Adult Burns Service at the Alfred Hospital in Melbourne, Australia.

Trials showed that a number of different dressing types, including polyurethane films, hydrocolloid gels and biosynthetic dressings, can be more effective for treatment of moderate burns than SSD or standard chlorhexidine impregnated gauze dressings. As well as reducing healing times, some alternative dressings also reduced pain associated with burns.

Many of the trials, however, failed to adequately assess the depth of burns suffered, so the data was less easy to interpret. The researchers say there is a strong case for larger and better designed trials that will help inform doctors about the most appropriate treatments for burns of different severities.

"There is a need to clearly estimate burn depth in order to make proper recommendations as to the best products for treating burns," says Wasiak.

Wasiak J, Cleland H, Campbell F. Dressings for superficial and partial thickness burns. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD002106. DOI: 10.1002/14651858.CD002106.pub3.

Honey Helps To Heal Wounds

Honey may reduce healing times in patients suffering mild to moderate burn wounds. A systematic review by Cochrane Researchers concluded that honey might be useful as an alternative to traditional wound dressings in treating burns.

"We're treating these results with caution, but it looks like honey can help speed up healing in some burns," says lead researcher Dr Andrew Jull, of the Clinical Trials Research Unit at the University of Auckland, New Zealand.

Honey has been used in wound treatment since ancient times. The mechanism of action is unclear. While honey may help the body remove dead tissue and provide a favourable environment for the growth of new, healthy tissue, current interest in medicinal honey focuses largely on its antibacterial effects.

The review brings together data from 19 clinical trials involving 2554 patients with a range of different wounds. Honey was more effective in reducing healing time compared to some gauze and film dressings that are often used to treat moderate burns. However, the researchers were unable to show any clear benefits for the healing of grazes, lacerations, surgical wounds and leg ulcers.

The researchers don't advise using honey to treat other types of wounds. "Health services should invest in treatments that have been shown to work," says Dr Jull. "But, we will keep monitoring new research to try and establish the effect of honey."

Jull AB, Rodgers A, Walker N. Honey as a topical treatment for wounds. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD005083. DOI: 10.1002/14651858.CD005083.pub2.

Notes

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6. A new feature from The Cochrane Library for 2008: a collection of podcasts on a selection of Cochrane Reviews by the authors will be available from http://www.cochrane.org/podcasts from Wednesday 8th October 2008.

For Issue 4, 2008, the podcasts are:

- St John's wort for major depression
- Mouthrinses for the treatment of halitosis
- Procaine treatments for cognition and dementia
- Acupuncture and assisted conception
- Rehabilitation after lumbar disc surgery
- Mupirocin ointment for preventing Staphylococcus aureus infections in nasal carriers
- Organising health care services for persons with an intellectual disability
- Hospital at home versus in-patient hospital care
- Platinum versus non-platinum chemotherapy regimens for small cell lung cancer
- Increased police patrols for preventing alcohol-impaired driving
- Regular treatment with formoterol for chronic asthma: serious adverse events

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