Table 6 Summary of skin care/dressings and orthoses/splints
From: Hand surgery and hand therapy clinical practice guideline for epidermolysis bullosa
Key D = theoretical/foundational Quality of evidence: 1: systematic review with high bias risk, 3 = non-analytic studies, case reports, case series 4 = expert opinion ✓ = recommended best practice based on the clinical experience of the guideline development group Section 5A | |||
|---|---|---|---|
Outcome/recommendation | Recommendation strength | Quality of evidence | Key references |
Skin care/dressings | |||
First layer: non-adherent layer through the web spaces, covering the hand, around fingers. Second layer: wrapping gauze in “boxer’s” wrap fashion | D✓ | 4 | Panel opinion Panel’s survey (Appendix A) |
Dressing changes may begin in therapy/at home after the first 2–3 weeks. Prior, changes under anesthesia is recommended | D | 4 | |
Orthoses/splints | |||
Begin orthosis/splint use around week two to three, or when patient is tolerating dressing changes without anesthesia | D✓ | 3 | |
Continue full time use of orthoses/splints through week 4–6, then transition to night use only | D✓ | 4 | |
Skin must be monitored for break down and orthoses/splints altered as indicated | D✓ | 4 | |
We recommend long term use of nighttime orthoses/splints | D✓ | 4 | |