Effective Dressing Considering Adhesion and Absorptance in Treatment of Second Degree Facial Burn

PURPOSE: In second degree burn injuries of face, it is important to solve much discharge of early burn wound and shorten healing time. We introduce methodical and effective dressing in treatment of second degree facial burn at focus to solve much discharge of early burn wound and to shorten healing time. METHODS: From March, 2011 to December 2013, a study was done with 398 patients who had second degree burn wound on face. Initially we performed dressing with hydrofiber agent (Aquacel(R)). After cleansing with saline, Vasaline guaze was layed on face, and hydrofiber agent were layed over it, and Vasaline guaze was layed over there again, then saline wet guaze dressing performed. When we changed dressing daily, we evaluated burn wound degree. In superficial second degree burn wound like pinkish colored wound, we repeated hydrofiber agent and saline wet guaze dressing. In deep second degree burn wound like pale or mottled colored wound, we changed dressing with cultured allogenic keratinocyte (Kaloderm(R)). RESULTS: Number of patients with only superficial second degree burn wound was 272, with superficial second degree and deep second degree burn wound together was 113, with only deep second degree burn wound was 13. In only superficial second degree burn wound, the average healing time was 5.1 days with hydrofiber agent and saline wet dressing. In superficial second degree and deep second degree burn wound together, the average healing time was 7.2 days with hydrofiber agent and saline wet guaze dressing and cultured allogenic keratinocyte. In deep second degree burn wound, average healing time was 11 days with hydrofiber agent and saline wet guaze dressing and cultured allogenic keratinocyte. CONCLUSION: In this strategy, hydrofiber agent is good to be attached on irregular surface of facial burn wound, and we use hydrofiber agent to make wet environment to promotion wound healing, not as absorbable material. We use Saline wet guaze as absorbable material. And after evaluation of degree of burn, we use cultured allogenic keratinocyte to promote wound healing in case of deep second degree burn. We think this strategy using hydrofiber agent and saline wet gauze and cultured allogenic keratinocyte on facial burn wound is very effective dressing method.

Efficacy of Aquacell(R) Dressing in Partial Thickness Burn Patients

In partial thickness burn injuries, silver sulfadiazine cream 1%(SSD, Silvadene(R)) is the most commonly used topical agent worldwide. But silver sulfadiazine cream 1% has no exudate absorption property. Usually after escar is removed from wound surface, Silvadene(R) is changed to saline wet gauze dressing to promote epithelization. Aquacel(R)(ConvaTec, UK) is a 100% sodium carboxymethylcellulose Hydrofiber material. It absorbs exudates directly into the hydrofibers by vertical wicking which allows rapid uptake of liquid into the fibers. The absorbed exudate fluid can be distributed to the entire dressing rather than just over the wound surface, which results in larger fluid absorption capacity. From April, 2003 to July, 2004 a study was done with 40 patients who had variable partial thickness burns. Aquacel(R) dressing was compared in 21 cases to silver sulfadiazine cream 1% and saline wet gauze dressings in 19 cases. In the Aquacel(R) cases, the average healing time on the face was 5.36+/-1.69 a day; on the hands was 8.46+/-2.15 a day; and, on the neck was 6.0+/-2.0 a day. With the Silvadene(R) and Saline wet gauze dressing, the average healing time on the face was 6.44+/-1.74 a day; on the hands was 13.79+/-5.35 a day; and, on the neck was 11.17+/-3.31 a day. As a result, the Aquacel(R) group showed a shorter healing time compared to the Silvadene(R) and saline wet gauze dressing group and patients were satisfied because of less pain and improved comfort. In conclusion, Aquacel(R) is a better choice for partial thickness burn injuries because of shorter healing time, less pain and more confortable dressing.