Chong

Early HBOT did not influence burn depth or positive bacterial cultures in thermal burns

Clinical Bottom Line:

1. Hyperbaric oxygen was of no clear benefit

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Citation/s:Chong SJ, Kan EM, Song C, Soh CR, Lu J. Characterisation of early thermal burns and the effects of hyperbaric oxygen: a pilot study. Diving and Hyperbaric Medicine 2013 Sep;43(3):157-61

Lead author's name and fax:Si Jack Chong; Singapore General Hospital Three-part Clinical Question: Does early adjunctive HBOT reduce conversion of thermal burns to deeper injury?

Search Terms:Thermal burns; wound healing

The Study:Non-blinded randomised controlled trial with intention-to-treat.

The Study Patients:All patients had suffered injury secondary to a burn (flame, flash, scald, contact and in one case chemical) <24 hours prior to admission, were aged 21-60 and had <40% total burn surface area with regions of deep dermal or full thickness burns. Notably, patients with ANY co-morbidities were excluded, as were those who required airway protection.

Control group(N = 9; 6 analysed): Control group received 'standard' burns care at the Singapore General Hospital burns unit.

Experimental group(N = 8; 7 analysed): The above 'standard care' with the addition of HBOT - 2 sessions within 22 hours of admission - 90 minutes each at 243kPa breathing 100% O2.

The Evidence:

Outcome	Time to Outcome	Standard group	HBOT group	Relative risk reduction	Absolute risk reduction	NNT
Proportion of deep burns at 24 hrs that became superficial at 48 hrs	48 hours	0.11	0.25	125%	0.14	7
		95% CI:		-45% to 100%	-0.23 to 0.5	NNT 2 to INF; NNH 4 to INF
Proportion of superficial burns at 24 hours that became deep at 48 hours	48 hours	0.11	0.13	13%	0.01	71
		95% CI:		-100% to 290%	-0.29 to 0.32	NNT 3 to INF; NNH 3 to INF
Positive bacterial cultures	48 hours	0.44	0.25	44%	0.194	5
		95% CI:		-56% to 100%	-0.25 to 0.64	NNT 2 to INF; NNH4 to INF

Comments:

1. Very small study with low power to find important differences (planned 80 patients)

2. A lot of incomplete data.

3. White cell counts and cytokine levels were compared to averages from a non-burnt control population and found to be elevated at 48 hours, but with no significant difference between the HBOT and standard groups, the full data for this was not published.

4. One chemical burn included.

Appraised by:Craig Wilson; Thursday, 26 January 2017 Email: c.c.wilson@live.co.uk

Kill or Update By:December 2024

 

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