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Antisépticos para las quemaduras
Gill Norman, Janice Christie, Zhenmi Liu, Maggie J Westby, Jayne M Jefferies, Thomas Hudson, Jacky Edwards, Devi Prasad Mohapatra, Ibrahim A Hassan, Jo C Dumville | 12 julio 2017

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Temas

Study flow diagram
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Figure 1

Study flow diagram

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Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study
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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study

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Forest plot of comparison: 1 Additional Chinese herbs versus no additional Chinese herbs, outcome: 1.1 Cure rate.
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Figure 4

Forest plot of comparison: 1 Additional Chinese herbs versus no additional Chinese herbs, outcome: 1.1 Cure rate.

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Forest plot of comparison: 2 Additional topical HBOT versus additional systemic HBOT, outcome: 2.1 Cure rate.
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Figure 5

Forest plot of comparison: 2 Additional topical HBOT versus additional systemic HBOT, outcome: 2.1 Cure rate.

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Comparison 1 Additional Chinese herbs versus no additional Chinese herbs, Outcome 1 Cure rate.
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Analysis 1.1

Comparison 1 Additional Chinese herbs versus no additional Chinese herbs, Outcome 1 Cure rate.

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Comparison 2 Additional topical HBOT versus additional systemic HBOT, Outcome 1 Cure rate.
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Analysis 2.1

Comparison 2 Additional topical HBOT versus additional systemic HBOT, Outcome 1 Cure rate.

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Summary of findings for the main comparison. Summary of findings. Additional Chinese herbs compared with no additional Chinese herbs for treating gas gangrene

Additional Chinese herbs compared with no additional Chinese herbs for treating gas gangrene

Patient or population: patients with gas gangrene
Setting: a general hospital with 400 beds and 1.6 million outpatients per year
Intervention: additional Chinese herbs
Comparison: no additional Chinese herbs

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

№ of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with no Chinese herbs

Risk with Chinese herbs

Cure rate
follow up: range 2 weeks to 8 weeks

Study population

RR 3.08
(1.00 to 9.46)

46
(1 RCT)

⊕⊝⊝⊝
VERY LOW 1 2

150 per 1000

462 per 1000
(150 to 1000)

*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: Confidence interval; RR: Risk ratio.

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

1 Downgraded two levels due to limitations in design; high risk of performance and reporting bias, and unclear risk of bias in other bias sources.

2 Downgraded two levels due to imprecision; only one trial with small sample size and very wide confidence interval that included the possibility of an effect in either direction (crosses line of no effect).

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Summary of findings for the main comparison. Summary of findings. Additional Chinese herbs compared with no additional Chinese herbs for treating gas gangrene
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Summary of findings 2. Summary of findings. Additional topical HBOT compared with additional systemic HBOT for treating gas gangrene

Additional topical HBOT compared with additional systemic HBOT for treating gas gangrene

Patient or population: patients with gas gangrene
Setting: a general hospital with 520 beds and 0.2 million outpatients per year
Intervention: additional topical HBOT
Comparison: additional systemic HBOT

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

№ of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with systemic HBOT

Risk with Topical HBOT

Cure rate
follow up: mean 10 days

Study population

RR 1.10
(0.25 to 4.84)

44
(1 RCT)

⊕⊝⊝⊝
VERY LOW 1 2

130 per 1000

143 per 1000
(33 to 631)

*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: Confidence interval; RR: Risk ratio; HBOT: hyperbaric oxygen therapy.

GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

1 Downgraded two levels due to limitations in design; high risk of performance and reporting bias, and unclear risk of bias in selection and detection bias.

2 Downgraded two levels for imprecision; only one trial with small sample size and very wide confidence interval that included the possibility of an effect in either direction (crosses line of no effect).

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Summary of findings 2. Summary of findings. Additional topical HBOT compared with additional systemic HBOT for treating gas gangrene
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Table 1. Search strategies for databases in Chinese and trial registries

Search strategies

China Biological Medicine Database (CBM‐disc)

#1 "气性坏疽"[常用字段:智能]
#2 "梭菌"[常用字段:智能]
#3 "梭状"[常用字段:智能]
#4 "肌坏死"[常用字段:智能]
#5 "肌炎"[常用字段:智能]
#6 (#2) OR (#3)
#7 (#4) OR (#5)
#8 (#6) AND (#7)
#9 (#1) OR (#8)

China National Knowledge Infrastructure (CNKI)

(主题="气性坏疽") OR ((主题="梭菌"+"梭状") AND (主题="肌坏死"+"肌炎"))

Chinese scientific periodical database of VIP INFORMATION (VIP)

((题名或关键词=肌坏死 或 文摘=肌坏死 或 题名或关键词=肌炎 或 文摘=肌炎 与 专业=经济管理+图书情报+教育科学+自然科学+农业科学+医药卫生+工程技术+社会科学 与 范围=全部期刊) 与 (题名或关键词=梭状 或 文摘=梭状 或 题名或关键词=梭菌 或 文摘=梭菌 与 专业=经济管理+图书情报+教育科学+自然科学+农业科学+医药卫生+工程技术+社会科学 与 范围=全部期刊)) 或者 (题名或关键词=气性坏疽 或 文摘=气性坏疽 与 专业=经济管理+图书情报+教育科学+自然科学+农业科学+医药卫生+工程技术+社会科学 与 范围=全部期刊)

Science Citation Index

Gas gangrene or clostridi* myonecrosis

ClinicalTrials.gov (www.clinicaltrials.gov)

"Gas Gangrene"(By topics)

Current Controlled Trials (www.controlled‐trials.com)

"gas gangrene" or "myonecrosis"

WHO International Clinical Trials Registry Platform (www.who.int/trialsearch)

gas gangrene or clostridi* myonecrosis or non‐clostridi* myonecrosis or nonclostridi* myonecrosis

Australian New Zealand Clinical Trials Registry (www.anzctr.org.au)

"gas gangrene" or "clostridial myonecrosis" or "non‐clostridial myonecrosis" or "nonclostridial myonecrosis"

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Table 1. Search strategies for databases in Chinese and trial registries
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Comparison 1. Additional Chinese herbs versus no additional Chinese herbs

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Cure rate Show forest plot

1

46

Risk Ratio (M‐H, Fixed, 95% CI)

3.08 [1.00, 9.46]
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Comparison 1. Additional Chinese herbs versus no additional Chinese herbs
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Comparison 2. Additional topical HBOT versus additional systemic HBOT

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Cure rate Show forest plot

1

44

Risk Ratio (M‐H, Fixed, 95% CI)

1.10 [0.25, 4.84]
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Comparison 2. Additional topical HBOT versus additional systemic HBOT
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