Background: Deep dermal burns are initially difficult to evaluate. Some of these burns are able to heal spontaneously from the epidermal precursor cells found in hair follicles that were not destroyed by the injury. This type of healing is either slowed considerably or is unable to occur if the burn wound is covered with eschar or granulating surfaces. Leaving this necrotic tissue in place and covering the wound with a skin graft or occlusive dressing will create a closed fluid loculation that can then become infected and destroy viable epidermal cells thus converting a deep partial burn into a full thickness injury. Dermabrasion is a useful alternative to a more invasive and risky tangential excision. In a population with deep dermal partial-thickness (DDPT) burns, does dermabrasion with a biosynthetic wound dressing increase rate of wound healing?
Methods: Exhaustive search of available medical literature was conducted using Medline-OVID, CINAHL, Academic Search Premier, and Web of Science. The keywords dermabrasion, burns, and partial-thickness burns were used. Relevant articles were reviewed for studies analyzing patients with DDPT, DDPT combined with superficial partial thickness burns, DDPT combined with full thickness burns, and the use of dermabrasion with an occlusive biosynthetic dressing as a treatment method.
Results: Three studies met inclusion criteria and were included in this systematic review. Each study evaluated dermabrasion with a different biosynthetic wound dressing. One study reported a significantly reduced length of stay in an acute care setting, which lead to dramatic cost savings. Two studies evaluated occurrence of infection and reported nearly the same reduction in infection rates when dermabrasion and a biosynthetic dressing were used.
Conclusion: Based on the evidence found in the three reviewed studies, it is clear that additional research in the form of randomized control trials needs to be conducted to provide more conclusive evidence about how to treat deep dermal partial-thickness burns. The data presented by the three studies showed a decrease in length of hospital stay due to improved wound healing times, as well as decreased rate of infection. However, due to the limited sample size and the use of observational studies only, a strong recommendation for this treatment method in DDPT wounds cannot be made.
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