Single stage first layer biosynthetic cellulose dressing versus non-adherent gauze management in paediatric burns

Abstract

IntroductionPaediatric burn is a common emergency presentation with a variety of treatment options available. Major parental concerns include pain, healing and scarring, in addition to high parental anxiety. Epiprotect® is a biosynthetic cellulose-based sheet, applied as a single stage first layer contact dressing following initial debridement. Materials and MethodsA retrospective case control comparison study was carried out in our hospital on 28 patients, 14 with biosynthetic cellulose, and 14 with non-adherent gauze. Pain and parental anxiety were measured by the parental perception of child’s pain on Wong-Baker faces pain rating scale and STAI-6 questionnaire (compatible with the STAI-S scoring system) respectively in first clinic visit during outer dressing change. Scar score was calculated using the Vancouver scar scale (VSS). ResultsPatients in both groups had a similar demographic and clinical distribution of location, mechanism of burn, first aid, surface area and depth of burn. Pain and parental anxiety were significantly reduced in the cellulose dressing group (p = 0.0001). Time to complete healing were similar in both groups. Mean VSS scar score was 4 (1–5) in cellulose dressing group compared to 6 (4–11) in non-adherent gauze group (p = 0.0463). Two patients developed hypertrophied scar in non-adherent gauze group. The mean number of outpatient clinic visits in cellulose dressing group were 2.5 (1–5) as compared to 3 (2–6) in the non-adherent gauze group (p = 0.0607). ConclusionSingle stage first layer application of biosynthetic cellulose dressing is associated with reduced pain, parental anxiety, and improved scarring. The dressing is safe and can be applied to patients with superficial and mixed depth burns.