Varas 2005.

Methods	Country where data collected: USA Parallel‐group RCT (intra‐individual) Unit of randomisation: burn Unit of analysis: burn Duration: completion of treatment (max 14 days)
Participants	Inclusion criteria: partial‐thickness burn injuries requiring topical wound care that, in the opinion of the observer, would not go on to require surgical excision and grafting. The wounds had to involve two areas far enough apart so as not to create interference of the treatments. Wounds of similar sizes were chosen, but not specifically measured. Exclusion criteria: NR Participants: 14 people attending a hospital/burn centre Mean age (years): 41 (25‐68) Male participants: 13/14 Burn type: 12 flame, 2 scalding (both arms same cause) Burn degree: NR partial‐thickness Burn size (%TBSA): 14.6% (4.5–27) Burn location: upper extremities 8 vs 8, lower extremities 4 vs 6, trunk 2 vs 0
Interventions	Intervention arm 1: Acticoat‐ silver‐impregnated membrane applied wet and left in place; moistened and change of overlying dry gauze dressings every 6 h. 14 burns Intervention arm 2: SSD ‐ applied and removed then dressed with a dry gauze dressings twice daily. 14 burns Cointerventions: NR
Outcomes	Primary outcome: wound healing Secondary outcome: pain Secondary outcome: adverse events
Notes	Funding NR This was a "split‐body" or "intra‐individual" design where a person with two wounds had one wound randomised to each treatment. It was not clear whether the analysis took account of this.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "Randomization was performed by assignment using random drawing of sealed envelopes from a box with equal numbers of treatment and control envelopes. According to the protocol, the patient’s most left and/or upper‐most wound was labelled as wound #1, and the patient’s most right and/ or lower‐most wound was labelled as wound #2. Wound #1 was assigned randomly to one of the treatment algorithms, and wound #2 was assigned to the alternate algorithm." Comment: randomisation appeared adequate
Allocation concealment (selection bias)	Unclear risk	Quote: "Randomization was performed by assignment using random drawing of sealed envelopes from a box with equal numbers of treatment and control envelopes. According to the protocol, the patient’s most left and/or upper‐most wound was labelled as wound #1, and the patient’s most right and/ or lower‐most wound was labelled as wound #2. Wound #1 was assigned randomly to one of the treatment algorithms, and wound #2 was assigned to the alternate algorithm." Comment: it was unclear how well the allocation system was concealed
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Quote: "endpoint for dressings both in the inpatient and outpatient setting was based on the clinical judgment of the attending physicians at the Burn Center" Comment: unclear whether the outcome assessor was blinded to treatment allocation
Incomplete outcome data (attrition bias) All outcomes	High risk	Quote: "Fourteen patients were enrolled .....Four patients continued in the study until completion of treatment" Comment: very high proportion of participants did not complete treatment
Selective reporting (reporting bias)	Unclear risk	Comment: no specific quote but outcomes were not clearly specified in methods section so difficult to determine if all assessed outcomes reported
Other bias	Unclear risk	Comment: unclear whether the analysis adjusted for intra‐individual design