Comparison of locally-produced microcellulose dressing from Acetobacter xylinum with silver sulfadiazine cream in the treatment of acute superficial partial thickness burn wounds: A preliminary report

ABSTRACT

OBJECTIVES: To compare the efficacy, safety and cost of locally-produced microcellulose dressing from Acetobacter xylinum in promoting healing of superficial partial thickness burn wounds to standard dressing using silver sulfadiazine (SSD) cream and gauze in terms of the following time to healing, morbidity/infection rate, pain score, scarring and cost of dressingMETHODS: Comparative controlled trial. Each patient served as his own control, that is, one area was randomized to the treatment group dressed with microcellulose dressing, while another was assigned to the control group dressing with SSD. Both areas were inspected regularly for signs of infection, as well as reepithelialization. The patients were also asked for the pain score at rest, and during dressing using the visual analog scale. Once healed, the Vancouver scale was used to grade the resultant scars.RESULTS: Ten patients were included from February to June 2008. All patients were males, with a mean age of 30.1 years (17-48 years, ± 12.05), and a mean total body surface involvement of 12.75% (4-22% TBSA,?± 7.0) superficial partial thickness burns. The time in days to complete reepithelialization was significantly lower in MCD dressings (p-value=0.05760). The mean times (in days) to complete reepithelialization for MCD and SSD were 11.4 (90 percent CI 9.80-13.0) and 13.8 (90 percent CI 12.33-15.27) days, respectively. Statistical analysis of differences of VAS scores during dressing changes were significantly lower in MCD dressing on days 2,6,9 and 12 post burn. Background VAS scores were also lower in those patients with MCD dressing on days 6, 9 and 12 post burn. None of the wounds in either treatment arm had signs of infection. Scarring of wounds dressed with MCD were better, based on the Vancouver scar score than those dressed with SSD (p = 0.0299). The means for the Vancouver score for MCD and SSD were 2.65 (90 percent CI 2.25-3.05) and 4.05 (90 percent CI 3.32-4.78), respectively.CONCLUSION: Microcellulose dressing is significantly more effective than silver sulfadiazine in treatment of second degree burn wounds in terms of number of days to full reepithelialization and quality of scarring. Dressing with MCD was less painful on days 2, 6, 9 and 12 post burn. Background VAS scores were also lower on days 6, 9 and 12 post burn. None ofthe wounds in both treatment arms had signs of infection throughout the treatment period.