目标:在烧伤的成年人中,非侵入性治疗是否能改善疼痛和烧伤疤痕瘙痒,弹性和血管化?干预期后是否仍有效果?
方法:采用meta分析对随机试验进行系统评价。
方法:有烧伤疤痕的成年人。
方法:实验干预是非侵入性的(即,非手术或非药物)治疗应用于烧伤疤痕。
方法:疼痛强度,瘙痒强度,弹性和血管化。
结果:纳入了15项试验,涉及780名参与者。结果表明,按摩后0至10量表对疼痛强度有有益影响(MD-1.5,95%CI-1.8至-1.1),冲击波治疗(MD-0.8,95%CI-1.2至-0.4)和激光(MD-4.0,95%CI-6.0至-2.0)。结果表明,按摩后0至10量表对瘙痒强度有有益作用(MD-0.4,95%CI-0.7至-0.2),冲击波治疗(MD-1.3,95%CI-2.3至-0.3)和激光(MD-4.8,95%CI-6.1至-3.5)。按摩,冲击波疗法和硅胶对瘢痕弹性和血管形成的益处可忽略不计或不清楚。证据质量从低到中等不等。
结论:在所有常用的治疗烧伤瘢痕的非侵入性疗法中,低到中等质量的证据表明,按摩,激光和冲击波治疗减轻疼痛和疤痕瘙痒的强度。低到中等质量的证据表明,按摩,冲击波疗法和硅胶对改善瘢痕弹性和血管形成的作用可忽略不计或不明确。
背景:PROSPERO(CRD42021258336)。
In adults with a burn injury, do non-invasive therapies improve pain and burn scar pruritus, elasticity and vascularisation? Are any effects maintained beyond the intervention period?
Systematic review of randomised trials with meta-analyses.
Adults with burn scars.
The experimental intervention was a non-invasive (ie, non-surgical or non-pharmacological) therapy applied to the burn scar.
Pain intensity, pruritus intensity, elasticity and vascularisation.
Fifteen trials involving 780 participants were included. The results indicated a beneficial effect on pain intensity on a 0-to-10 scale after massage (MD -1.5, 95% CI -1.8 to -1.1), shockwave therapy (MD -0.8, 95% CI -1.2 to -0.4) and laser (MD -4.0, 95% CI -6.0 to -2.0). The results indicated a beneficial effect on pruritus intensity on a 0-to-10 scale after massage (MD -0.4, 95% CI -0.7 to -0.2), shockwave therapy (MD -1.3, 95% CI -2.3 to -0.3) and laser (MD -4.8, 95% CI -6.1 to -3.5). Massage, shockwave therapy and silicone produced negligible or unclear benefits on scar elasticity and vascularisation. The quality of evidence varied from low to moderate.
Among all commonly used non-invasive therapies for the treatment of burn scars, low-to-moderate quality evidence indicated that massage, laser and shockwave therapy reduce pain and the intensity of scar pruritus. Low-to-moderate quality evidence suggested that massage, shockwave therapy and silicone have negligible or unclear effects for improving scar elasticity and vascularisation.
PROSPERO (CRD42021258336).