Yap, Nathanael Q E

Silver foam dressings have been extensively used in the management of burn injuries; however, its application in children requires elucidation. A literature search was conducted from database inception to October 2023. Eligible studies reported paediatrics patients under 21 years of age receiving silver dressings for burns or scalds. This review was registered prospectively with PROSPERO (CRD42023470239). 18 studies met the inclusion criteria with a total of 701 patients. The pooled mean time to re-epithelisation (TTRE) was 12.9 days (95% CI: 11.2, 14.6, I2 = 94%). The pooled mean duration of hospitalisation was 9.8 days (95% CI: 3.9, 15.7; I2 = 100%). Mean number of total dressing changes per patient was 3.6 (95% CI: 2.2, 4.9; I2 = 99%). There were a total of 98 complications, including 30 (30.6%) infections, 29 (29.6%) surgical requirements, 14 (14.3%) hypertrophic scarring, 17 (17.3%) escalations of care, 5 (5.1%) burn depth progression, and 3 (3.1%) others. Silver foam dressings appear as a safe and effective approach in terms of healing rate and dressing change frequency for selected paediatric patients with burn injuries. Despite the promising results, further comparative studies are required to evaluate the selection criteria and long-term effect of silver foam dressing.

Abstract Background Caesarean sections (CSs) constitute a large proportion of fetal deliveries, yet no consensus exists on optimal surgical method. Objectives To investigate the safety and efficacy of the Pfannenstiel‐Kerr method (PKM) in comparison to Misgav‐Ladach method (MLM) and Modified Misgav‐Ladach method (MMLM) for CS. Search Strategy Cochrane, Embase, PubMed, CiNAHL, Scopus, and Web of Science were searched from database inception to March 2023. Selection Criteria Prospective studies comparing MLM with PKM or MMLM with PKM. Data Collection and Analysis Three authors independently conducted data extraction and assessed quality. Pooled means and proportions were analyzed using inverse variance and Mantel‐Haenszel methods. Main Results Twenty‐seven studies with 15 251 patients, met the selection criteria. Both MLM (mean difference [MD]: −12.09 min, 95% confidence interval [CI]: −14.40, −9.77, Tau 2 = 16.79, I 2 = 97%), (MD: −125.98 mL, 95% CI: −172.13, −79.83, Tau 2 = 3458.59, I 2 = 87%) and MMLM (MD: −11.38 min, 95% CI: −14.72, −8.04, Tau 2 = 30.56, I 2 = 100%), (MD: −62.61 mL, 95% CI: −103.13, −22.09, Tau 2 = 1451.35, I 2 = 92%) demonstrated shorter operative time and decreased blood loss, respectively, compared to PKM. Similarly, both MLM (MD: −1.70 min, 95% CI: −2.26, −1.14, Tau 2 = 0.51, I 2 = 97%), (MD: −0.77 d, 95% CI: −1.35, −0.19, Tau 2 = 0.60, I 2 = 98%) and MMLM (MD: −2.80 min, 95% CI: −3.89, −1.70, Tau 2 = 1.74, I 2 = 100%), (MD: −0.58 d, 95% CI: −1.00, −0.17, Tau 2 = 0.29, I 2 = 100%) demonstrated shorter fetal extraction time and length of hospital stay, respectively, compared to PKM. Conclusions MLM and MMLM should be considered safe and effective alternative approaches to CSs.