Inclusion criteria
Types of participants
This review will consider studies that include patients of any age who have sustained a burn injury of any size and have been admitted to a burns unit for the management of their injury.
Types of intervention(s)/phenomena of interest
This review will consider studies that evaluate any type of moisturizing cream following burn injury. Participants will have received standard burns wound management. Studies that include moisturizer use in combination with other predefined scar management strategies will be considered for inclusion. The moisturizer creams may be compared to placebo, usual care, other interventions or a different type of moisturizer.
Types of outcomes
Primary outcomes that will be examined in this review include scar formation and skin breakdown. These outcomes may be measured by objective tools or subjective scales.
Secondary outcomes that will be examined in this review include patient product acceptance/compliance, and TEWL. These outcomes may be measured by objective tools (such as Tewameters) or subjective scales.
Types of studies
This review will primarily consider experimental study designs including randomized and pseudo-randomized controlled trials. Where randomized controlled trials are not available, this review will consider other study designs including non-randomized controlled trials, quasi-experimental, before and after studies, prospective and retrospective cohort studies, case series and case studies for inclusion.
Search strategy
The search strategy aims to find both published and unpublished studies. A three-step search strategy will be utilized in this review. An initial limited search of PubMED and CINAHL will be undertaken followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe article. A second search using all identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. All studies identified and published in English will be considered for inclusion in this review. No date limits will be applied.
The databases to be searched include:
PubMED, CINAHL, EMBASE and Web of Science.
The search for unpublished studies will include:
clinicaltrials.gov (US Clinical Trials Register), http://www.anzctr.org.au (Australian and New Zealand Clinical Trials Register), http://www.controlled-trials.com (European Clinical Trials Register), Mednar, http://www.opengrey.eu, and Cochrane Central Register of Controlled Trials (CENTRAL).
Initial keywords to be used will be:
moisturizer, moisturiser, burn injury, burn, burns, thermal injury, scar, trans epidermal water loss, aqueous cream, emollient, hydration
Assessment of methodological quality
Papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) (Appendix I ). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer.
Data collection
Data will be extracted from papers included in the review using the standardized data extraction tool from JBI-MAStARI (Appendix II ). For missing information or data that needs clarification, the authors of primary studies will be contacted. Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. The data extracted will include specific details about the interventions, populations, study methods and outcomes of significance to the review question and specific objectives.
Data synthesis
Quantitative data will, where possible be pooled in statistical meta-analysis using JBI-MAStARI. All results will be subject to double data entry. Effect sizes expressed as odds ratio (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals will be calculated for analysis. Heterogeneity will be assessed statistically using the standard Chi-square and also explored using subgroup analyses based on the different study designs included in this review where and if appropriate. Subgroup analysis may also be performed based on different interventions or population groups. Where statistical pooling is not possible the findings will be presented in narrative form including tables and figures to aid in data presentation where appropriate.
Conflicts of interest
The authors have no known conflicts of interest to declare.
References