Treatment of post-burn pruritus - A systematic review and meta-analysis

Abstract

Background: Post-burn pruritus is one of the most common complaints reported by patients with limited evidence for a gold-standard treatment.

Objective: To review the literature and assess the efficacy of various interventions in treating post-burn pruritus.

Methods: PubMed, MEDLINE, CINAHL, Web of Sciences, Ovid Databases, and ClinicalTrials.Gov were searched. The articles were scored by two assessors for inclusion with a third independent assessor resolving conflicting scores.

Results: The present systematic review and meta-analysis synthesised findings from a total of nine studies, representing a pool of 323 patients. The standardized mean effect size for the various categories of interventions was: naltrexone at 1.47 (95 % CI of 0.75-2.20, p < 0.0000), coverings at 0.94 (95 % CI of 0.40-1.48, p = 0.006), topical ozonated oil at 2.64 (95 % CI of 1.94-3.34, p < 0.00001), lasers at 2.34 (95 % CI of 1.60-3.09, p < 0.00001), current stimulation at 1.03 (95 % CI of -0.04 to 2.10, p = 0.06), and lemon balm tea at 0.54 (95% CI of 0.12-0.96, p = 0.01).

Conclusions: Current evidence suggests that current modalities have a statistically significant, but not clinically significant, reduction in pruritus. This review highlights the limited quality of evidence in the literature and the poor quality of reporting among excluded studies.

Keywords: Burn; Itch; Pruritus.