Randomized controlled trial of three burns dressings for partial thickness burns in children

  • E L Gee Kee University of Queensland
  • R M Kimble University of Queensland
  • L Cuttle University of Queensland
  • A Khan University of Queensland
  • K A Stockton University of Queensland
Keywords: child, burn, partial thickness, silver dressing, re-epithelialization, pain

Abstract

Background: This study compared the effects of three silver dressing combinations on small to medium size acute partial thickness burns in children, focusing on re-epithelialization time, pain and distress during dressing changes. Method: Children (0–15 years) with clean, ≤10% total body surface area (TBSA) partial thickness burns who met the inclusion criteria were included in the study. Children received either (1) ActicoatTM; (2) ActicoatTM with MepitelTM; or (3) Mepilex AgTM dressings. Measures of burn re-epithelialization, pain, and distress were recorded at dressing changes every 3–5 days until full re-epithelialization occurred. Results: One hundred and three children were recruited with 96 children included for analysis. No infections were detected for the course of the study. When adjusted for burn depth, ActicoatTM significantly increased the expected days to full re-epithelialization by 40% (IRR = 1.40; 95% CI: 1.14–1.73, p < 0.01) and ActicoatTM with MepitelTM significantly increased the expected days to full re-epithelialization by 33% (IRR = 1.33; 95% CI: 1.08–1.63, p _ 0.01) when compared to Mepilex AgTM. Expected FLACC scores in the Mepilex AgTM group were 32% lower at dressing removal (p = 0.01) and 37% lower at new dressing application (p = 0.04); and scores in the ActicoatTM with MepitelTM group were 23% lower at dressing removal (p = 0.04) and 40% lower at new dressing application (p < 0.01), in comparison to the ActicoatTM group. Expected Visual Analog Scale-Pain (VAS-P) scores were 25% lower in the Mepilex AgTM group at dressing removal (p = 0.04) and 34% lower in the ActicoatTM with MepitelTM group (p = 0.02) at new dressing application in comparison to the ActicoatTM group. There was no significant difference between the Mepilex AgTM and the ActicoatTM with MepitelTM groups at all timepoints and with any pain measure. Conclusion: Mepilex AgTM is an effective silver dressing, in terms of accelerated wound epithelialization time (compared to AticoatTM and ActicoatTM), with MepilexTM) and decreased pain during dressing changes (compared to ActicoatTM), for clean, <10% TBSA partial thickness burns in children.

Author Biographies

E L Gee Kee, University of Queensland
Centre for Children’s Burns and Trauma Research Queensland Children’s Medical Research Institute University of Queensland Australia
R M Kimble, University of Queensland
Centre for Children’s Burns and Trauma Research Queensland Children’s Medical Research Institute University of Queensland; and Stuart Pegg Paediatric Burns Centre Royal Children’s Hospital Australia
L Cuttle, University of Queensland
Centre for Children’s Burns and Trauma Research Queensland Children’s Medical Research Institute University of Queensland; and Tissue Repair and Regeneration Program Institute of Health and Biomedical Innovation Queensland University of Technology Australia
A Khan, University of Queensland
School of Health and Rehabilitation Sciences University of Queensland Australia
K A Stockton, University of Queensland
Centre for Children’s Burns and Trauma Research Queensland Children’s Medical Research Institute University of Queensland Australia
Section
Wound Care