332 Topical Steroids for Suppression of Granulation Tissue in Burns: Results of an ABA Member Survey

Abstract

The presence of granulation tissue in burn wounds, especially hypergranulation, may negatively influence healing time and contribute to the development of hypertrophic scarring and contractures. Topical corticosteroids have been reported to suppress the inflammatory response that contributes to the growth of granulation tissue however literature about this treatment in burns is limited. We have previously presented the results of a European Burns Association (EBA) survey about the use of topical steroids for suppression of granulation tissue in burns, where it was shown to be quite widespread (77% of responders). The aim of this study was to explore this use amongst members of the ABA, and compare it to that of the EBA. Members of the ABA were asked to complete an online anonymous questionnaire regarding their experience with the use of topical steroids for suppression of granulation tissue in burns. The survey included questions regarding the responders’ profession and years of experience, number of patients treated yearly, experience with the use of topical steroids in burn care, and questions related to the safety and efficacy of this treatment for those experienced with its use. Eighty-four questionnaires were completed by 52 physicians (62%), 23 nurses (27%), and 9 other burn care professionals (11%) with an average of 14.5 years of experience in burn care, and an average of 300 burn patients treated per year. Fifty (60%) responded they were inexperienced in the use of topical steroids for suppression of granulation tissue in burns, the major reason stated was that they were unfamiliar with this treatment option (31 of 50 responders, 62%). Thirty-four (40%) of the responders were experienced in the use of topical steroids for suppression of granulation tissue in burns. All but one of those experienced with this treatment found it safe and effective (97%). Twenty-three (68%) estimated they treated up to 30 burn patients with topical steroids per year, and 10 (29%) estimated they treated >30 patients per year. The largest area size treated varied, with most responders in the range of 1-10% TBSA, however 5 (15%) treated areas up to 11-20% TBSA, and 5 others (15%) treated areas >20% TBSA. Treatment course duration median was 5-7 days. Only 2 of the 34 experienced responders (6%) witnessed possible systemic side effects, in ≤ 1% of the patients they treated. The use of topical steroids for suppression of granulation tissue in burn care appears to be quite common in the US (40%), although it is almost twice more common in Europe (77%). The vast majority of experienced users in both surveys found it a safe and effective treatment. Topical steroids for suppression of granulation tissue in burn care appear to be safe and effective.