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      Effect of Virtual Reality-Based Interventions on Pain During Wound Care in Burn Patients; a Systematic Review and Meta-Analysis

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          Abstract

          Introduction:

          Burn patients undergo daily painful wound care procedures, including washing, debridement, and dressing. This systematic review and meta-analysis aimed to examine the effect of virtual reality (VR)-based interventions on pain during wound care in burn patients.

          Methods:

          A comprehensive systematic search was conducted on international electronic databases such as Scopus, PubMed, and Web of Science with keywords extracted from Medical Subject Headings such as "Virtual reality", "Virtual reality therapy", "Virtual reality exposure therapy", "Virtual reality immersion therapy", "Exergaming”, “Active-video gaming”, “Burns”, “Wound healings”, “Pain”, and “Pain management” from the earliest to May 6, 2022. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to assess the quality of randomized control trials and quasi-experimental studies.

          Results:

          1,293 patients with burns were included in 30 studies, and their mean age was 22.89 (SD=7.63) years. 70.72% of the participants were male, and 67.05% were in the intervention group. This meta-analysis showed that VR significantly decreased pain severity in the intervention group compared to the control group (standard mean difference (SMD): -0.70, 95%CI: -0.97 to -0.43, Z=5.05, P<0.001, I 2:82.0%). Immersive VR intervention showed statistically significant effects in reducing pain intensity among the intervention group, compared to the control group (SMD: -0.73, 95%CI: -0.97 to -0.49, Z=5.88, P<0.001, I 2:69.3%); however, this finding was not the same for non-immersive VR (SMD: -0.62, 95%CI: -1.43 to 0.19, Z=1.51, P=0.132, I 2:91.2%).

          Conclusion:

          It is suggested that health policymakers and managers equip burn wards with immersive VR devices to provide the basis for this intervention when caring for patients with burn wounds.

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          Most cited references84

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
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            Cochrane Handbook for Systematic Reviews of Interventions

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              Biological control agent Rhizobium (= Agrobacterium ) vitis strain ARK-1 suppresses expression of the essential and non-essential vir genes of tumorigenic R. vitis

              Objective To gain insights into the virulence suppressive mechanism of a nonpathogenic strain of Rhizobium vitis ARK-1, we co-inoculated ARK-1 with a tumorigenic (Ti) strain of R. vitis to examine the expression of two essential virulence genes (virA and virG) and one non-essential gene (virD3) of the Ti strain at the wound site of grapevine. Results Co-inoculation of ARK-1 with a Ti strain VAT03-9 at a 1:1 cell ratio into grapevine shoots resulted in significantly lower expression of the virulence genes virA, virD3, and virG of VAT03-9 at 1 day after inoculation compared with those when shoots were inoculated only with VAT03-9. ARK-1 was not able to catabolize acetosyringone, which is the plant-derived metabolites inducing the entire vir regulon in Ti strains, suggesting the direct effect of ARK-1 on the induction of broad range of vir genes of R. vitis Ti strains. Electronic supplementary material The online version of this article (10.1186/s13104-018-4038-6) contains supplementary material, which is available to authorized users.
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                Author and article information

                Journal
                Arch Acad Emerg Med
                Arch Acad Emerg Med
                AAEM
                Archives of Academic Emergency Medicine
                Shahid Beheshti University of Medical Sciences (Tehran, Iran )
                2645-4904
                2022
                24 October 2022
                : 10
                : 1
                : e84
                Affiliations
                [1 ]Department of Medical Informatics, faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
                [2 ]Student Research Committee, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
                [3 ]Student Research Committee, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
                [4 ]Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran.
                [5 ]Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran.
                [6 ]Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
                [7 ]Department of Nursing, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran.
                [8 ]Department of Medical Physics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
                [9 ]School of Nursing and Midwifery, Faculty of Health, Community, and Education, Mount Royal University, Calgary, Ab, Canada.
                [10 ]Quchan School of Nursing, Mashhad University of Medical Sciences, Mashhad, Iran.
                Author notes
                [* ]Corresponding Author: Mohammadreza Mobayen; Mohammadreza Mobayen; Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran. Tel: +98-9125139506; +98-13-33552088; Email: mohammadreza.mobayen@yahoo.com, ORCID: https://orcid.org/0000-0001-9317-4955.
                []Corresponding Author: Samad Karkhah; Nursing and Midwifery School of Shahid Dr Beheshti, Hamidyan Shahrak, Shahid Dr Beheshti Ave., Rasht, Guilan, Iran. Fax: +98-13-33550097; Postal code: 41469-39841, Tel: +98-9032598167; +98-13-33552088; Email: sami.karkhah@yahoo.com, ORCID: https://orcid.org/0000-0001-9193-9176.
                Article
                10.22037/aaem.v10i1.1756
                9676699
                36426174
                1cedb30f-3ff8-461e-85a5-7b8c1d256fe5

                This open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0). ( https://creativecommons.org/licenses/by-nc/3.0/)

                History
                : July 2022
                : August 2022
                Categories
                Review Article

                virtual reality,burns,wound healing,pain,pain management,systematic review,meta-analysis

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