Comment on Dinesen et al. Diphoterine for Chemical Burns of the Skin: A Systematic Review. Eur. Burn J. 2023, 4, 55–68

Round 1

Reviewer 1 Report

The authors give a very interesting comment to the authors of the systematic review.

I have some comments on the letter:

Line 4 and 8: as far as I know, Dr. Jacquemin is no longer working in the burn center of CHU Liège. This should be corrected.

Line 15-18: this phrase is too complicated, it should be rephrased.

Line 21: ‘They both act as flushing solutions that aim to remove mechanically the chemical from skin surface’. Shouldn’t it be: They both act as flushing solutions that aim to mechanically remove the chemical from the surface of the skin.

Line 24-25: ‘has yet…’ instead of ‘have yet…’?

Line 48: rinsing instead of washing?

Line 61: risk of hypothermia for the burn patient instead of the user since someone else can use the rinsing solution.

Line 61-62: can the authors explain the washing as it is confusing with the rinsing/flushing. Does the user of Diphoterine® have to mechanically wash the patient with the solution as this has to be clear for the reader.

I think the manuscript should be reviewed by the first or last authors who should be native English speakers.

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

Title: Comment on Dinesen et al. "Diphoterine for Chemical Burns of the Skin: A Systematic Review"

The authors have recognised that Dinesen et al. have carried out a thorough systematic review according to the aim of their study. The manuscript reads well.

The comment also includes interesting and relevant facts about chemical burns and flushing solutions. The reasoning about preclinical studies is interesting, although that was outside the scope of the study by Dinesen et al.

The statement that aggregated case reports (and case series) can form evidence for treatment effects is, on the other hand, problematic due to the lack of control of: patient selection; illness severity; and in this case also treatment dose. The scientific value of case reports in general is mainly that rare conditions or drug side effects can be aggregated and thereby understood (risk, symptoms, and course) by clinicians that seldom or never encounter them.

Author Response

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Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Thank you for responding to all of my questions and making the necessary corrections. I have no further comments.