Cochrane · systematic review · CD011821
Antiseptics for burns
Norman, G, Christie, J, Liu, Z, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
WoundsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
36
current version
GRADE rated
32
No studies
4
Included studies
NR
No studies 4 · 11.1%Ungraded 0 · 0%Very low 16 · 44.4%Low 12 · 33.3%Moderate 3 · 8.3%High 1 · 2.8%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Silver‐based antiseptics versus topical antibiotics
Population: people with burns
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Wound healing: time to complete healing (time‐to‐event data) Silver‐based antiseptics vs topical antibiotics | HR 1.25 [0.94, 1.67] | 3 studies · 259 participants | Low Downgraded: risk of bias, imprecision |
Wound healing (mean time to healing) Silver‐based antiseptics vs topical antibiotics | no estimate extracted | 10 studies · 1085 participants | Low Downgraded: risk of bias, inconsistency |
Wound healing (number of healing events) Silver‐based antiseptics vs topical antibiotics | RR 1.17 [1, 1.37] | 5 studies · 408 participants | Low Downgraded: risk of bias, imprecision |
Infection Silver‐based antiseptics vs topical antibiotics | RR 0.84 [0.48, 1.49] | 4 studies · 309 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Silver‐based antiseptics vs topical antibiotics | RR 0.86 [0.63, 1.18] | 6 studies · 440 participants | Low Downgraded: risk of bias, imprecision |
Honey versus topical antibiotics
Population: people with burns
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Wound healing: time to complete healing (time‐to‐event data): honey versus SSD or mafenide acetate Honey vs topical antibiotics | HR 2.45 [1.71, 3.52] | 5 studies · 580 participants | Moderate Downgraded: imprecision |
Wound healing (mean time to healing): honey versus SSD Honey vs topical antibiotics | no estimate extracted | 6 studies · 712 participants | Very low Downgraded: imprecision, inconsistency |
Wound healing (number of healing events): honey versus SSD Honey vs topical antibiotics | RR 2.18 [1.15, 4.13] | 4 studies · 318 participants | Low Downgraded: imprecision, inconsistency |
Incident infection: honey versus SSD or mafenide acetate Honey vs topical antibiotics | RR 0.16 [0.08, 0.34] | 4 studies · 480 participants | Very low Downgraded: imprecision, indirectness |
Peristent infection: honey versus SSD Honey vs topical antibiotics | RR 0.1 [0.05, 0.19] | 2 studies · 170 participants | Very low Downgraded: imprecision, indirectness |
Adverse events: honey versus SSD Honey vs topical antibiotics | RR 0.2 [0.01, 3.97] | 3 studies · 250 participants | Very low Downgraded: risk of bias, imprecision |
Aloe vera versus topical antibiotics
Population: people with burns
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Wound healing (number of healing events): Aloe Vera versus SSD Aloe vera vs topical antibiotics | RR 1.41 [0.7, 2.85] | 1 study · 38 participants | Low Downgraded: imprecision |
Wound healing (mean time to healing): Aloe Vera versus SSD or framycetin Aloe vera vs topical antibiotics | no estimate extracted | 3 studies · 210 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Infection: Aloe Vera versus SSD Aloe vera vs topical antibiotics | RR 0.93 [0.26, 3.34] | 3 studies · 221 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events Aloe vera vs topical antibiotics | no estimate extracted | NR | No studies |
Iodine versus topical antibiotics
Population: people with burns
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Wound healing (mean time to healing) Iodine vs topical antibiotics | no estimate extracted | 2 studies · 148 participants | Very low Downgraded: risk of bias, imprecision |
Infection Iodine vs topical antibiotics | no estimate extracted | NR | No studies |
Adverse events Iodine vs topical antibiotics | RR 0.86 [0.35, 2.1] | 1 study · 40 participants | Very low Downgraded: risk of bias, imprecision |
Silver versus non‐antibacterial
Population: people with burns
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Wound healing (number of healing events): silver xenograft vs petroleum gauze Silver vs non‐antibacterial | RR 1.13 [0.59, 2.16] | 1 study · 32 participants | Low Downgraded: imprecision |
Wound healing (mean time to healing): silver nanoparticle vs Vaseline gauze Silver vs non‐antibacterial | no estimate extracted | 2 studies · 204 participants | Moderate Downgraded: imprecision |
Infection Silver vs non‐antibacterial | no estimate extracted | NR | No studies |
Adverse events Silver vs non‐antibacterial | no estimate extracted | NR | No studies |
Honey versus non‐antibacterial
Population: people with burns
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Wound healing: time to complete healing (time‐to‐event data) Honey vs non‐antibacterial | HR 2.86 [1.6, 5.11] | 2 studies · 164 participants | Moderate Downgraded: imprecision |
Wound healing (mean time to healing) Honey vs non‐antibacterial | no estimate extracted | 4 studies · 1156 participants | High |
Infection (incident) Honey vs non‐antibacterial | RR 0.47 [0.23, 0.98] | 1 study · 92 participants | Very low Downgraded: imprecision, indirectness |
Infection (persistent) Honey vs non‐antibacterial | RR 0.15 [0.06, 0.4] | 2 studies · 147 participants | Very low Downgraded: imprecision, indirectness |
Adverse events Honey vs non‐antibacterial | no estimate extracted | 3 studies · 239 participants | Very low Downgraded: imprecision, indirectness |
Chlorhexidine versus non‐antibacterial
Population: people with burns
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Wound healing: time to complete healing (time‐to‐event data): chlorhexidine versus polyurethane Chlorhexidine vs non‐antibacterial | HR 0.71 [0.39, 1.29] | 1 study · 51 participants | Low Downgraded: imprecision |
Wound healing (mean time to healing): chlorhexidine versus non‐antibacterial Chlorhexidine vs non‐antibacterial | MD 4.08 [0.73, 7.43] | 1 study · 51 participants | Low Downgraded: imprecision |
Infection: chlorhexidine versus no antimicrobial/no additional antimicrobial Chlorhexidine vs non‐antibacterial | RR 1.11 [0.54, 2.27] | 2 studies · 172 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events: chlorhexidine versus hydrocolloid Chlorhexidine vs non‐antibacterial | RR 0.2 [0.02, 1.65] | 1 study · 98 participants | Very low Downgraded: risk of bias, imprecision |
Iodine versus non‐antibacterial
Population: people with burns
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Wound healing (number of healing events): iodophor versus hydrogel Iodine vs non‐antibacterial | RR 0.17 [0.08, 0.34] | 1 study · 120 participants | Low Downgraded: imprecision |
Wound healing (mean time to healing): iodine gauze versus carbon fibre Iodine vs non‐antibacterial | MD 5.38 [3.09, 7.67] | 1 study · 277 participants | Very low Downgraded: imprecision, inconsistency |
Wound healing (mean time to healing): iodophor versus MEBO Iodine vs non‐antibacterial | no estimate extracted | 1 study · 55 participants | Very low Downgraded: imprecision, inconsistency |
Infection: iodine gauze versus MEBO Iodine vs non‐antibacterial | RR 1.3 [0.47, 3.61] | 1 study · 211 participants | Low Downgraded: imprecision |
Adverse effects: iodine gauze versus MEBO Iodine vs non‐antibacterial | RR 0.71 [0.3, 1.69] | 1 study · 211 participants | Low Downgraded: imprecision |