Comparative effectiveness and cost assessment of polymer dressings for acute partial-thickness burns: a systematic review and meta-analysis

What is it about?

Partial-thickness burns pose a significant clinical challenge globally. While conventional treatments like silver sulfadiazine (SSD) remain common, polymer-based dressings have emerged as effective alternatives. These dressings aim to relieve pain, speed healing, minimise frequent changes and improve cost-effectiveness. This systematic review and meta-analysis evaluate polymer-based dressings’ efficacy, tolerability, and economic implications in treating acute partial-thickness burns. Seven electronic databases (PubMed, Scopus, CINAHL, Cochrane Clinical Trials, Medline, Embase, and Web of Science) were searched from 1990 to March 2025, following PRISMA guidelines. Randomised controlled trials (RCTs) and comparative cohort studies evaluating polymer-based dressings versus traditional treatments (such as SSD and paraffin gauze) or other polymer dressings were included. These studies were categorised into silver-based, non-silver-based, and multiple polymer dressings. The risk of bias was assessed using the RoB 2 and ROBINS-I tools. A meta-analysis on pain scores and healing times was performed, using standardised mean differences (SMD) and visualised through forest and funnel plots. Twenty-nine studies were included in the qualitative synthesis, with seven suitable for meta-analysis. Findings showed significant pain score reductions for polymer dressings compared to SSD (SMD=-0.61, 95% CI: -0.99 to -0.22), paraffin gauze (SMD=-0.96, 95% CI: -1.21 to -0.70), and other polymers (SMD=-0.71, 95% CI: -0.79 to -0.63). The polymer group also significantly improved healing time over SSD (SMD=-1.05, 95% CI: -1.38 to -0.71). Mepilex Ag consistently demonstrated benefits in pain relief, fewer dressing changes, and cost-effectiveness, followed by Aquacel Ag and Askina Calgitrol Ag. Non-silver dressings, such as bacterial cellulose and chitosan-based materials, had positive results, especially in pain management and patient comfort. Polymer-based dressings like Mepilex Ag and Aquacel Ag yield superior outcomes and economic value for acute partial-thickness burns.

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