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Introduction: Collagen is an endogenous substance, which forms an important structural component in connective tissue andis of special importance in the skin. The importance of collagen in healing has been appreciated for many years for the simplereason that the end result of wound healing is always a scar which is composed of collagenous fibers.Aims: This prospective randomized controlled study was designed to compare the effectiveness of collagen dressing and silversulfadiazine dressing in partial-thickness burns.Materials and Methods: This study was conducted at Government Royapettah Hospital, Chennai. A total of 60 patients withpartial-thickness burn wounds were included in this study, and they are divided into two groups. Group 1 consisted of 30 patientsin whom collagen dressing was done. Group 2 consisted of 30 patients in whom silver sulfadiazine dressing was done. Thevariables analyzed were pain score, infection rate, the rate of healing of the wound, resultant scar, and patient compliance.Patients with partial-thickness burns involving <40% of the total body surface area and wounds not older than 24 h are inclusioncriteria in the study, whereas patients with full-thickness burns, burns involving >40% of the total body surface area, woundsolder than 24 h, and facial burns are the exclusion criteria for this study.Results: The average pain score in the range of 0–10 was 7.10 in the silver sulfadiazine group and 2.87 in the collagen group.Infection was present in 40% of the patients in the silver sulfadiazine group, whereas it was only 13.3% in the collagen group. Insilver sulfadiazine group, healing was achieved on an average of 17.77 days, whereas in the collagen group, it took 11.80 days.Conclusion: Collagen sheet promotes early healing, decreases the need for analgesics, and reduces the incidence of associatedcomplications such as infection. The morbidity of the patients is reduced as the resultant scar is better in the majority of thepatients using collagen. Due to the simple application and good tolerance of the membrane, collagen can be advocated as atemporary biological dressing material in partial-thickness burns.
ABSTRACT
<p><b>INTRODUCTION</b>The ideal burn dressing for children should aim to alleviate pain, decrease length of hospital stay and minimise complications such as conversion and infection. The current literature is still inconclusive with regard to the gold standard burn dressing for the paediatric population.</p><p><b>METHODS</b>We retrospectively reviewed children with superficial partial thickness burns admitted to our paediatric burns unit from January 2014 to April 2015. A total of 30 patients were included in our study, of whom 13 had Biobrane dressing. The remaining 17 patients were treated with conventional silver foam dressing (i.e. Biatain Ag) and served as matched controls. Long-term follow-up scar evaluation was carried out at an average interval of two years after injury.</p><p><b>RESULTS</b>In the Biobrane group, the length of hospital stay was significantly shorter (Biobrane vs. silver foam: 4.76 ± 2.64 days vs. 8.88 ± 5.09 days; p = 0.01) and the infection rate was significantly lower (Biobrane vs. silver foam: 0% vs. 35.3%; p = 0.02). The Biobrane group had no hypergranulation or wound infection and did not require skin grafting. Long-term follow-up scar evaluation did not reveal any statistical difference between the patient groups at the two-year interval.</p><p><b>CONCLUSION</b>Paediatric patients with partial thickness burns treated with Biobrane dressing had shorter hospital stay and lower incidence of infection compared to those treated with conventional silver foam dressing. Biobrane and silver foam dressings did not demonstrate any significant difference in terms of long-term scar outcomes over an average follow-up duration of two years.</p>
ABSTRACT
Background: The treatment of burn injuries with Silver Sulfadiazine is used in many burn centers. Objective: Determine the duration of clinical reepithelization in children treated with enriched Silver Sulfadiazine, according to sex, age, neutral zone burned (thorax - abdomen - limbs without joint damage), extention, presence of infections, bandage adherence and derivation to rehabilitation. Method: Retrospective review of 263 clinical records during 2004 that fulfilled the items for inclusion (children age under 15 years-old, with burn injuries of partial thickness caused by scalding liquids, treated at COANIQUEM Acute Unit with Silver Sulfadiazine plus Lidocaine plus Vitamin A and not needing grafts). Normal and median position between period of clinical reepithelization and variables considered with p < 0.05 were proven. Results: The median for clinical reepithelization was 10 days (range 5 - 23); if rehabilitation was required: 15 days and not required: 9 days (p < 0.0001). Lower limbs, children under 5 years-old and girls need longer reepithelization time. 0.4%> cases presented infections and 1.1% gauze adherence. Conclusions: Duration of clinical reepithelization with enriched Silver Sulfadiazine, associated to low infection rate and few adverse effects make it highly efficient for ambulatory treatments.
Introducción: Tratamiento de quemaduras con sulfadiazina de plata, sigue siendo de uso frecuente en muchos centros. Objetivo: Determinar el tiempo de re-epitelización clínica en niños con quemaduras por líquidos calientes, tratados con sulfadiazina de plata, su variación según sexo, edad, zona neutra (tórax-abdomen, extremidades sin compromiso articular) extensión, presencia de infecciones, adherencia de aposito y derivación a rehabilitación. Metodología: Revisión retrospectiva de 263 fichas que cumplieron con requisitos de inclusión (niños < 15 años, con quemaduras causadas por líquidos calientes, de espesor parcial, ingresados al Policlínico de Agudos de COANIQUEM en 2004, tratados con sulfadiazina de plata más lidocaína y vitamina A, que no fueron injertados). Se probó normalidad y posición de medianas entre período de reepitelización y según las distintas variables, se utilizó distribución percentilar como medida de tendencia central y prueba de Kruskal Wallis para la comparación de los grupos considerando p < 0,05 significativo. Resultados: Mediana de reepitelización clínica fue de 10 días (rango 5-23) para grupo total; 15 días para los con derivación a rehabilitación y de 9 días para los que fueron dados de alta (p < 0,0001). Demoró más la reepitelización en extremidades inferiores, niños menores de 5 años y mujeres. 0,4% presentó infección y 1,1% gasa adherida. Conclusiones: Duración de reepitelización clínica con sulfadiazina de plata, sumada a la baja tasa de infección y escasos efectos adversos, aporta alta confiabilidad a este método en curaciones ambulatorias.
ABSTRACT
Thirty nine partial thickness burns ranging from 0.5% to 6% total surface body area in thirty two patients were treated with the application of freeze dried irradiated amnion during an eighteen month period from July 1989 to December 1990. It was observed that in all these burns wounds, there was relief of pain upon application and control of oozing from the wound. In addition, healing of the wounds was unremarkable with no occurrence of infection. Scab separation was completed at an average of 9.9 days. Freeze dried, irradiated amnion was found to be effective as a biologic dressing in the treatment of burns for prolonged periods using this unique storage process.(Author)