Is the time right to put down the knife? A call for evidence-based decision making

_Dear Sir,_ With great interest we read the work of Dr. Edmondson et al. entitled ‘Time to start putting down the knife: A systematic review of burns excision tools of randomized and non-randomized trials’. We highly appreciate their effort to evaluate existing evidence for excision techniques other than the standard of care (sharp tangential excision with a knife). Their distinct review shows that there is only limited evidence for the use of alternative techniques, like hydrosurgical or enzymatic debridement. In the Netherlands, both techniques are increasingly used for the debridement of deep partial thickness and subdermal burns. Although healthcare professionals are increasingly encouraged to bring scientific evidence into their care planning and decision making, the choice of the debridement technique still depends on the burn specialists and no algorithm is available to guide them in this decision. Also, techniques might be used interchangeably, or more than one technique might be used on the same burn wound in different phases of the treatment. [...]