oa Wound Healing Southern Africa - Randomized controlled trial of three burns dressings for partial thickness burns in children : wound care
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) Acticoat; (2) Acticoat with Mepitel; or (3) Mepilex Ag dressings. Measures of burn reepithelialization, 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, Acticoat significantly increased the expected days to full re-epithelialization by 40% (IRR = 1.40; 95% CI: 1.14-1.73, p < 0.01) and Acticoat with Mepitel 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 Ag. Expected FLACC scores in the Mepilex Ag group were 32% lower at dressing removal (p = 0.01) and 37% lower at new dressing application (p = 0.04); and scores in the Acticoat with Mepitel group were 23% lower at dressing removal (p = 0.04) and 40% lower at new dressing application (p < 0.01), in comparison to the Acticoat group.Expected Visual Analog Scale-Pain (VAS-P) scores were 25% lower in the Mepilex Ag group at dressing removal (p = 0.04) and 34% lower in the Acticoat with Mepitel group (p = 0.02) at new dressing application in comparison to the Acticoat group. There was no significant difference between the Mepilex Ag and the Acticoat with Mepitel groups at all timepoints and with any pain measure.
Conclusion: Mepilex Ag is an effective silver dressing, in terms of accelerated wound epithelialization time (compared to Acticoat and Acticoat with Mepitel) and decreased pain during dressing changes (compared to Acticoat), for clean, <10% TBSA partial thickness burns in children.
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