Reply to Hall et al. 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
Please check 'offer' in sentence 24, it should be 'offers' I think, otherwise I have no comments.
Author Response
Thank you for your comment. This has been corrected.
Reviewer 2 Report
I liked your letter to the editor. I am someone who is interested in these topics. it's a nice article.
Author Response
Thank you.
Reviewer 3 Report
Based on the answer of the authors and their affiliation, it seems that the authors do not have any experience with Diphoterine. Doing a prospective, randomized study would be extremely unethical because patients would recieve suboptimal treatment for their chemical burns. Just with basic chemistry (the company is always willing to show this), it can be proven that it takes so much more time to reduce the pH - remove the chemical substance - with water compared to Diphoterine.
Therefore, I do not agree with the answer of the authors.
Author Response
Thank you for your comment. We highly agree that all patients should receive optimal treatment but we respectfully disagree that implementation of new treatments should be done before a beneficial effect has been detected in clinical studies conducted by researchers who have a genuine scientific interest in the field as opposed to a financial interest. The scientific community has learned that designing medical interventions based on clever ideas alone can result in a bad outcome.
Reviewer 4 Report
Title: Reply Letter to Comment on Dinesen et al. "Diphoterine for Chemical Burns of the Skin: A Systematic Review"
The letter reads well. The authors have responded to the issues raised by Hall et al. in a polite, factual, and scientifically sound way.
Author Response
Thank you for your comment.
Round 2
Reviewer 3 Report
I have read the authors' comments and can understand their general point of view. Only not in the specific case of dangerous chemical burns where there is a specialized product available. The randomization of patients in a group where this product would not be used would is in my opinion - given my extensive personal experience and with no financial interest - be unethical.
Author Response
We are pleased to share an understanding of the importance of well conducted studies in general. As it appears in our reply letter, we highly agree that randomized studies in this field can be a huge challenge for several reasons, but we still think it is problematic to implement a new product based on in vitro studies and personal experience. Therefore, we would encourage centers that have not yet implemented a new, less examined product to perform thorough, prospective studies before implementation.
