Comparisons of the Effects of Biological Membrane (Amnion) and Silver Sulfadiazine in the Management of Burn Wounds in Children

Abstract

This prospective study was conducted on 102 children with second-degree thermal burns to assess qualitative differences between topical silver sulfadiazine (SD) and oven-dried, radiation-sterilized human amnion as wound dressing. The patients were divided into silver SD and amniotic membrane (AM) group by random sampling technique. The variables compared 1) the number of days admitted in the hospital, 2) the number of dressing changes, 3) time needed for epithelialization, 4) comfort and pain of the patients during dressing, 5) comfort and pain of the patients between dressings, 6) activities during treatment, 7) acceptability of the modules by the patients or attending guardians, and 8) comfort of the doctor during application. Patients' ages ranging from 1 day to 12 years and admitted to inpatient burn unit within 72 hours of occurrence were included in this study. Fifty-one burned children enrolled in each group. The mean hospital stay is significantly lower in AM group (P < .01). The number of dressing changes in AM group was significantly low (P < .001). The mean time taken for epithelial coverage of superficial second-degree burns is significantly lower in AM than in SD group (P < .001) and also those of deep second-degree burns (P < .001). Application was painless in AM than SD group (P < .001). State of pain in-between application shows significant difference (P < .001). Application of AM was comfortable to the attending doctor (P < .001). Significant activity of the patients was observed during treatment (P < .01) with AM. AM was accepted by the patients or parents (P < .001). This study indicates that radiation-sterilized, oven-dried AM is a better treatment option because its use reduces hospital stay and the number of dressing changes. Epithelialization of the wound is quicker. The use of AM is painless and odorless. The procedure is easy and comfortable to the doctor, and it is well accepted. Most of the patients remain ambulatory during treatment.