Dr Fadie Aziz1, Dr Andrea Issler-Fisher1,2,3, Dr Francesca Dudas1
1Concord Repatriation General Hospital, , Australia, 2ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia, 3Concord Clinical School, University of Sydney, Sydney, Australia
Introduction: Burns related pruritus is a common and often distressing manifestation of burns, with a reported incidence of 93% in all burns patients. The physical, psychological and social consequences can be severe, including impairment of daily activities, poor sleep and having the potential to cause wound breakdown and infection due to itching. Despite its frequency and morbidity, there are still many unknowns about the pathophysiology of burn pruritus, and equally about the ideal treatment modality. The aim of this systematic review is to shed light on the available literature on burns related pruritus management.
Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a comprehensive systematic review of the published literature in Medline, EMBASE and Pubmed databases was performed. Search criteria included “burns” and “pruritis”. Studies assessing the effectiveness of treatment modalities were included. Isolated case reports, reviews and surveys were excluded
Results: 43 papers were selected using the search criteria and were subsequently reviewed by authors. Treatment modalities were either pharmacological agents including anti-histamines, gabapentin and naltrexone, or non-pharmacological therapies including compression garments, CO2 laser and shock wave therapy.
Conclusion: Burns related Pruritis remains a difficult to treat symptom of burn injury, one that may persist following healing and cause significant impairment to quality of life. This systematic review demonstrates that there are multiple treatment modalities which have been shown to be effective. Knowledge and access to these modalities provides clinicians with an armamentarium for this often difficult to treat condition.
I am a Surgical SRMO, currently rotating through the Burns Unit at Concord Repatriation General Hospital. My interests include emergency burns care, reconstructive burns surgery and scar management. I find burns to be a dynamic and highly rewarding field and am committed to burns research and education.