Partial Burns Research Articles

Prospective, randomised controlled trial comparing Versajet™ hydrosurgery and conventional debridement of partial thickness paediatric burns

IntroductionConventional surgical debridement of burn wounds consists of tangential excision of eschar using a knife or dermabrasion until viable dermis or punctate bleeding occurs. The Versajet™ (Smith and Nephew, St. Petersburg, FL, USA) hydrosurgery system has also been advocated for burn wound debridement, with the suggestion that enhanced preservation of dermal tissue might reduce subsequent scarring. MethodsA prospective randomised controlled trial was undertaken comparing Versajet™ to conventional debridement. After excluding those with facial burns, 61 children ≤16 years of age undergoing debridement and skin grafting for partial thickness burns were recruited. Adequacy of debridement was assessed by 2mm punch biopsies taken pre- and post-debridement. Surgical time, percentage graft take at day 10, time to healing, post-operative infection and scarring at 3 and 6 months were assessed. ResultsThirty-one children underwent conventional debridement and 30 debridement using Versajet™. There was a significant difference in the amount of viable dermal preservation between the two groups (p=0.02), with more viable tissue lost in the conventional group (median 325μm) versus the Versajet™ group (median 35μm). There was no significant difference between graft take at day 10 (p=0.9), post-operative wound infection (p=0.5), duration of surgery (p=0.6) or time to healing after grafting (p=0.6). Despite better dermal preservation in the Versajet™ group, there was no significant difference between scarring at 3 or 6 months (p=1.0, 0.1). ConclusionsThese findings suggest that Versajet™ hydrosurgery appears a more precise method of burn wound debridement. Although dermal preservation may be a factor in reducing subsequent hypertrophic scarring, there were no significant differences found between scarring at 3 or 6 months after-injury.

Invited Review: Combustion instability in spray-guided stratified-charge engines: A review

This article reviews systematic research on combustion instabilities (principally rare, random misfires and partial burns) in spray-guided stratified-charge (SGSC) engines operated at part load with highly stratified fuel -air -residual mixtures. Results from high-speed optical imaging diagnostics and numerical simulation provide a conceptual framework and quantify the sensitivity of ignition and flame propagation to strong, cyclically varying temporal and spatial gradients in the flow field and in the fuel -air -residual distribution. For SGSC engines using multi-hole injectors, spark stretching and locally rich ignition are beneficial. Combustion instability is dominated by convective flow fluctuations that impede motion of the spark or flame kernel toward the bulk of the fuel, coupled with low flame speeds due to locally lean mixtures surrounding the kernel. In SGSC engines using outwardly opening piezo-electric injectors, ignition and early flame growth are strongly influenced by the spray's characteristic recirculation vortex. For both injection systems, the spray and the intake/compression-generated flow field influence each other. Factors underlying the benefits of multi-pulse injection are identified. Unresolved questions include (1) the extent to which piezo-SGSC misfires are caused by failure to form a flame kernel rather than by flame-kernel extinction (as in multi-hole SGSC engines); (2) the relative contributions of partially premixed flame propagation and mixing-controlled combustion under the exceptionally late-injection conditions that permit SGSC operation on E85-like fuels with very low NOx and soot emissions; and (3) the effects of flow-field variability on later combustion, where fuel-air-residual mixing within the piston bowl becomes important.

Topical clobetasol in conjunction with topical tretinoin is effective in preventing scar formation after superficial partial-thickness burn ulcers of the skin: A retrospective study

Background: Deep erythema and inflammation after re-epithelialization of superficial wounds is a sign of scar formation. Corticosteroids may prevent scarring by suppression of inflammation and fibroblast activity. Tretinoin may increase the efficacy of corticosteroids in this setting. Objective: To evaluate the efficacy of corticosteroids plus tretinoin for prevention of scars after superficial wounds. Methods: In a retrospective study of patients with superficial partial thickness thermal skin burn, we compared the patients who received clobetasol plus tretinoin after re-epithelialization with patients who did not receive any medication. Clobetasol propionate 0.05% ointment was used twice daily with overnight occlusive dressing in conjunction with twice weekly topical tretinoin 0.05% cream. Results: Among 43 patients who had light pink or no erythema after re-epithelialization and consequently did not receive clobetasol + tretinoin, no scar was developed. Among patients who had deep erythema after re-epithelialization, rate of scar formation was significantly higher in 14 patients who did not receive clobetasol + tretinoin than in 21 patients who received clobetasol + tretinoin (64% and 19%, respectively; p = 0.01). Conclusion: Clobetasol + tretinoin can significantly decrease the incidence of scar formation in patients with inflammation after re-epithelialization of superficial wounds.

PIV examination of spray-enhanced swirl flow for combustion stabilization in a spray-guided stratified-charge direct-injection spark-ignition engine

Practical implementation of spray-guided stratified-charge direct-injection spark-ignition engines can be inhibited by combustion instability, in particular the occurrence of misfire and partial burns. Performance testing in an all-metal spray-guided stratified-charge direct-injection spark-ignition engine shows that increasing the engine speed from 1000 to 2000 r/min can cause a deterioration of the combustion stability for operation without intake-generated swirl. Introducing swirl to the in-cylinder air charge motion maintains combustion stability while the speed is increased. To gain understanding how swirl reduces cycle-to-cycle variability of the flow, two-dimensional Particle Image Velocimetry (PIV) measurements were made in a horizontal swirl plane near the top of the piston bowl and in a central vertical tumble plane. Tests with and without injection were conducted at 1000 and 2000 r/min for operation both with and without swirl. The results demonstrate that the swirl creates flow patterns in each cycle that are more similar to the ensemble-averaged cycle, and with decreased variability. Furthermore, the fuel injection causes a redistribution of angular momentum resulting from spray–swirl interaction. The gas-phase swirl flow is redistributed by the spray to create a very repeatable vortex with enhanced angular momentum close to the spray centerline. This decreases the cycle-to-cycle variability of the flow patterns. Quantified changes in the stability of the flow patterns with swirl and engine speed are consistent with the combustion-instability trends.

Investigation of operating range in a methanol fumigated diesel engine

An experimental study was conducted to investigate the operating range and combustion characteristics in a methanol fumigated diesel engine. The test engine was a six-cylinder, turbocharged direct injection engine with methanol injected into the intake manifold of each cylinder. The experimental results showed that the viable diesel methanol dual fuel (DMDF) operating range in terms of load and methanol substitution percent (MSP) was achieved over a load range from 6% to 100%. The operating range was restricted by four bounds: partial burning, misfire, roar combustion and knock. The lower bound of the operating range was the partial burn bound, which occurred under very low load conditions with high MSP. As the load increased to medium load, MSP reached its maximum value of about 76%, and the onset of misfire provided the right bound for normal operation. At medium to high load, maximum MSP began to decrease. DMDF combustion with excessive MSP was extremely loud with high pressure rise rate, which defined the roar combustion bound. As it increased to nearly full load, measured pressure traces in-cylinder showed strong acoustic oscillations. The appearance of knock provided the upper bound of the operating range. In general, as the load increased, the characters of the combustion changed from partial burn to misfire to roar combustion and to knocking. The range between these four bounds and the neat diesel combustion bound constituted the viable operating range. Over the viable operating range, DMDF combustion worsened the brake thermal efficiency (BTE) at light load while boosted it at medium and high load.

Combined effects of flow/spray interactions and EGR on combustion variability for a stratified DISI engine

This study investigates combustion variability of a stratified-charge direct-injection spark ignited (DISI) engine, operated with near-TDC injection of E70 fuel and a spark timing that occurs during the early part of the fuel injection. Using EGR, low engine-out NOx can be achieved, but at the expense of increased combustion variability at higher engine speeds. Initial motored tests at different speeds reveal that the in-cylinder gas flow becomes sufficiently strong at 2000rpm to cause significant cycle-to-cycle variations of the spray penetration. Hence, the fired tests focus on operation at 2000rpm with N2 dilution ([O2]=19% and 21%) to simulate EGR. In-cylinder flow, spray, and early-flame measurements are correlated to reveal their effect on the combustion variability.Results reveal two types of flow/spray-interactions that predict the likelihood of a partial burn. (1) Proper flow direction before injection with a more collapsed spray leads to high kinetic energy of the flow during injection, thus generating a rapid early burn, which ensures complete combustion, regardless of the EGR level. (2) Improper flow direction and less collapsed spray generate low flow energy during the early phase of combustion. For this second type of flow/spray-interaction, application of EGR results in a partial-burn frequency of 30%, whereas without EGR, early combustion is shown to be insensitive to flow variations. Flame-probability maps illustrate that the partial-burn cycles for operation with EGR have a weak flame development in that the flame does not develop uniformly and reliably from the spark plug. Without EGR, the flame development is more repeatable regardless of the type of flow/spray-interaction, at the expense of higher NOx emissions.

Effect of Corrosives and Partial Burn on The Insects’ Succession and Decay of Buried Cadaver in Different Types of Soil

Effect of Corrosives and Partial Burn on The Insects’ Succession and Decay of Buried Cadaver in Different Types of Soil

Stromal vascular fraction improves deep partial thickness burn wound healing

ObjectiveThe practice of early burn wound excision and wound closure by immediate autologous skin or skin substitutes is the preferred treatment in extensive deep partial and full-thickness burns. To date there is no proven definite medical treatment to decrease burn wound size and accelerate burn wound healing in modern clinical practice. Stromal vascular fraction is an autologous mixture that has multiple proven beneficial effects on different kinds of wounds. In our study, we investigated the effects of stromal vascular fraction on deep partial-thickness burn wound healing. MethodsIn this study, 20 Wistar albino rats were used. Inguinal adipose tissue of the rats was surgically removed and stromal vascular fraction was isolated. Thereafter, deep second-degree burns were performed on the back of the rats by hot water. The rats were divided into two groups in a randomized fashion. The therapy group received stromal vascular fraction, whereas the control group received only physiologic serum by intradermal injection. Assessment of the burn wound healing between the groups was carried out by histopathologic and immuno-histochemical data. ResultsStromal vascular fraction increased vascular endothelial growth factor, proliferating cell nuclear antigen index, and reduced inflammation of the burn wound. Furthermore, vascularization and fibroblastic activity were achieved earlier and observed to be at higher levels in the stromal vascular fraction group. ConclusionsStromal vascular fraction improves burn wound healing by increasing cell proliferation and vascularization, reducing inflammation, and increasing fibroblastic activity.

On the ignition and flame development in a spray-guided direct-injection spark-ignition engine

High-speed fuel, flow, and flame imaging are combined with spark discharge measurements to investigate the causes of rare misfires and partial burns in a spray-guided spark-ignited direct-injection (SG-SIDI) engine over a range of nitrogen dilution levels (0–26% by volume). Planar laser induced fluorescence (PLIF) of biacetyl is combined with planar particle image velocimetry (PIV) to provide quantitative measurements of equivalence ratio and flow velocity within the tumble plane of an optical engine. Mie scattering images used for PIV are also used to identify the enflamed region to resolve the flame development. Engine parameters were selected to mimic low-load idle operating conditions with stratified fuel injection, which provided stable engine performance with the occurrence of rare misfire and partial burn cycles. Nitrogen dilution was introduced into the intake air, thereby displacing the oxygen, which destabilized combustion and increased the occurrence of poor burning cycles. Spark measurements revealed that all cycles exhibited sufficient spark energy and duration for successful ignition. High-speed PLIF, PIV, and Mie scattering images were utilized to analyze the spatial and temporal evolution of the fuel distribution and flow velocity on flame kernel development to better understand the nature of poor burning cycles at each dilution level. The images revealed that all cycles exhibited a flammable mixture near the spark plug at spark timing and a flame kernel was present for all cycles, but the flame failed to develop for misfire and partial burn cycles. Improper flame development was caused by slow flame propagation which prevented the flame from consuming the bulk of the fuel mixture within the piston bowl, which was a crucial step to achieve further combustion. The mechanisms identified in this work that caused slower flame development are: (1) lean mixtures, (2) external dilution, and (3) convection velocities that impede transport of the flame into the fuel mixture.

Toxic Epidermal Necrolysis and Graft-versus-Host Reaction: Revisiting a Puzzling Similarity

Drug-induced toxic epidermal necrolysis (TEN) and acute cutaneous graft-versus-host reaction (GVHR) under immunopreventive therapy share some histopathological resemblance. So far, there are no serum biomarkers and no immunohistochemical criteria distinguishing with confidence and specificity the skin lesions of TEN and GVHR. Both diseases present as an inflammatory cell-poor necrotic reaction of the epidermis. This report compares three sets of 15 immunostaining patterns found in TEN, GVHR, and partial thickness thermal burns (PTTB), respectively. Three series of 17 skin biopsies were scrutinized. Irrespective of the distinct causal pathobiology of TEN and GVHR, similar secondary effector cells were recruited in lesional skin. Burns were less enriched in cells of the monocyte-macrophage disease. These cells likely exert deleterious effects in TEN and GVHR and cannot be simply regarded as passive bystanders. These life-threatening conditions are probably nursed, at least in part, by macrophages.

Development and application of methods for the determination of silver in polymeric dressings used for the care of burns

Open vessel and microwave digestion methods have been developed for the determination of total silver in six commercial dressing used for the treatment of skin burns. An extraction method using TMAH has also been developed to determine the amount of silver present in the exudates found on the surface after dressing removal so an estimation of the patient dose can be made. All microwave methods had a quantitative recovery, whereas the open vessel had recoveries that ranged from 80 to 100%. The silver concentrations were determined by inductively coupled plasma mass spectrometry using an external calibration. In the absence of suitable reference materials, isotope dilution analysis was applied to validate the accuracy of results obtained by external calibration. All the products had a total Ag content that agreed with the values declared by the producer, which ranged from 10 to 0.2% Ag by weight. One of the methods was applied to the indirect determination of Ag released in vivo by Acticoat™ Flex 3, a dressing composed of silver nanoparticles on a polymer net. Silver levels were determined in used dressings after application to patients with partial thickness skin burns. A maximum of 62% of the silver was found to have been released onto the patient where hemopurulent exudate occured, indicating that the dressing was virtually exhausted after 3 days of use. We conclude that the Ag released into the patient's tissues is closely correlated with the local severity of the wound.

Performance of diesel cycle engine-generator operating on dual fuel mode with gasification gas

The Brazilian Federal Government aims to expand the electrical energy supply to the low income Brazilian citizen through Light for Everyone Program. The objective of this study was to use the program as a vector of social and economical development. One of the obstacles was to reach even the isolated communities. In this work, the performance of a cycle diesel motor generator running in dual mode, diesel and gasification gas, as an option for decreases, the dependence on diesel by the isolated communities was evaluated. The process was based on obtaining gas through the partial biomass burn, which in high temperatures is converted to fuel gas that may be used in internal combustion engine. Among the results, it was observed that there is a reduction of 30.7% in the diesel consumption, a better voltage adjustment and a maximum current at the generator, leading to a power increase of 43.8% saving R$ 0.86 for each kW h -1 . These results show the possibility of using the biomass gasification to decrease the diesel consumption to produce electricity in the isolated communities. Keywords : Energy, biomass, diesel consumption reduction, gasifier African Journal of Biotechnology Vol. 12(10), pp. 1148-1154

Foreskin-isolated keratinocytes provide successful extemporaneous autologous paediatric skin grafts

Severe burns in children are conventionally treated with split-thickness skin autografts or epidermal sheets. However, neither early complete healing nor quality of epithelialization is satisfactory. An alternative approach is to graft isolated keratinocytes. We evaluated paediatric foreskin and auricular skin as donor sources, autologous keratinocyte transplantation, and compared the graft efficiency to the in vitro capacities of isolated keratinocytes to divide and reconstitute epidermal tissue. Keratinocytes were isolated from surgical samples by enzymatic digestion. Living cell recovery, in vitro proliferation and epidermal reconstruction capacities were evaluated. Differentiation status was analysed, using qRT-PCR and immunolabelling. Eleven children were grafted with foreskin-derived (boys) or auricular (girls) keratinocyte suspensions dripped onto deep severe burns. The aesthetic and functional quality of epithelialization was monitored in a standardized way. Foreskin keratinocyte graft in male children provides for the re-epithelialization of partial deep severe burns and accelerates wound healing, thus allowing successful wound closure, and improves the quality of scars. In accordance, in vitro studies have revealed a high yield of living keratinocyte recovery from foreskin and their potential in terms of regeneration and differentiation. We report a successful method for grafting paediatric males presenting large severe burns through direct spreading of autologous foreskin keratinocytes. This alternative method is easy to implement, improves the quality of skin and minimizes associated donor site morbidity. In vitro studies have highlighted the potential of foreskin tissue for graft applications and could help in tissue selection with the prospect of grafting burns for girls.

Alternative erythropoietin-mediated signaling prevents secondary microvascular thrombosis and inflammation within cutaneous burns

Alternate erythropoietin (EPO)-mediated signaling via the heteromeric receptor composed of the EPO receptor and the β-common receptor (CD131) exerts the tissue-protective actions of EPO in various types of injuries. Herein we investigated the effects of the EPO derivative helix beta surface peptide (synonym: ARA290), which specifically triggers alternate EPO-mediated signaling, but does not bind the erythropoietic EPO receptor homodimer, on the progression of secondary tissue damage following cutaneous burns. For this purpose, a deep partial thickness cutaneous burn injury was applied on the back of mice, followed by systemic administration of vehicle or ARA290 at 1, 12, and 24 h postburn. With vehicle-only treatment, wounds exhibited secondary microvascular thrombosis within 24 h postburn, and subsequent necrosis of the surrounding tissue, thus converting to a full-thickness injury within 48 h. On the other hand, when ARA290 was systemically administered, patency of the microvasculature was maintained. Furthermore, ARA290 mitigated the innate inflammatory response, most notably tumor necrosis factor-alpha-mediated signaling. These findings correlated with long-term recovery of initially injured yet viable tissue components. In conclusion, ARA290 may be a promising therapeutic approach to prevent the conversion of partial- to full-thickness burn injuries. In a clinical setting, the decrease in burn depth and area would likely reduce the necessity for extensive surgical debridement as well as secondary wound closure by means of skin grafting. This use of ARA290 is consistent with its tissue-protective properties previously reported in other models of injury, such as myocardial infarction and hemorrhagic shock.

An Open, Prospective, Randomized Pilot Investigation Evaluating Pain With the Use of a Soft Silicone Wound Contact Layer Vs Bridal Veil and Staples on Split Thickness Skin Grafts as a Primary Dressing

An open, prospective, randomized, pilot investigation was implemented to evaluate the pain, cost-effectiveness, ease of use, tolerance, efficacy, and safety of a soft silicone wound contact layer (Mepitel One) vs Bridal Veil and staples used on split thickness skin grafts in the treatment of deep partial or full-thickness thermal burns. Individuals aged between 18 and 70 years with deep partial or full-thickness thermal burns (1-25% TBSA) were randomized into two groups and treated for 14 days or until greater than 95% graft take was achieved, whichever occurred first. Data were obtained and analyzed on pain experienced before, during, and after dressing removal. Secondary considerations included the overall cost (direct), graft take and healing, the ease of product use, overall experience of the dressing, and adverse events. A total of 43 subjects were recruited. There were no significant differences in burn area profiles within the groups. The pain level during dressing removal was significant between the groups (P = .0118) with the removal of Mepitel One being less painful. The staff costs were lower in the group of patients treated with Mepitel One (P = .0064) as reflected in the shorter time required for dressing removal (P = .0005), with Mepitel One taking on average less than a quarter of the time to remove. There was no significant difference in healing between the two groups, with 99.0% of the Mepitel One group and 93.1% of the Bridal Veil and staples group showing greater than 95% graft take at post-op day 7 (+/-1) (P = .2373). Clinicians reported that the soft silicone dressing was easier to use, more conformable, and demonstrated better ability to stay in place, compared with the Bridal Veil and staples regime. Both treatments were well tolerated, with no serious adverse events in either treatment group. Mepitel One was at least as effective in the treatment of patients as the standard care (Bridal Veil and staples). In addition, the group of patients treated with the soft silicone dressing demonstrated decreased pain and lower costs associated with treatment.

Severe Burn Injuries Induced by PUVA Chemotherapy

Psoralen-ultraviolet A (PUVA) chemotherapy is an established treatment for certain skin diseases. Burn injury is a serious complication of PUVA therapy. Reports regarding this complication are limited. The aim of this study was to determine the management and outcome of severe PUVA burns. A retrospective review of the medical records of PUVA burns treated at our burn center from 2000 to 2010 was conducted. Data collected included age, sex, condition, mode of PUVA, site, surface area involved, depth of burns, onset of reactions, treatment, and inpatient stay. To evaluate the incidence of this severe complication, a survey of all listed burn care units in Germany, Austria, and Switzerland as well as the legal advisory boards of the medical associations of the federal states of Germany was conducted. The conditions leading to photochemotherapy were three cases of psoriasis vulgaris and one case of severe chronic graft vs host disease. All patients received oral psoralen. Incorrect handling of the radiation system was the reason for all burns. The mean affected TBSA was 73±18%. All patients were treated conservatively and healed without surgical intervention. Burn injury is a serious and preventable complication of PUVA photochemotherapy. Patients should be advised regarding the potential risk of major burns. Care should be given to not exceed the safe dose of psoralen. Burn care specialists must restrain surgical intervention as even deep partial thickness PUVA burns have the potential to heal spontaneously.

Different Surgical Treatment of Post-Burn Contracture of Foot and Ankle Joint

The foot and ankle scar post burn contractures are the result of deep partial and full-thickness burns that affect foot motion, impair the lower extremity function and benefit from surgical reconstruction. 76 patients (ages 2-46) with post burn foot and ankle joint contractures were treated at the Inter-regional Burn Center and burn department of RCSUMA Samarkand, Uzbekistan. The operations must be performed within 6-12 months after healing of burn wounds to prevent secondary changes. In the case when contracture is severe, the operation must be performed as soon as possible. The method of operation should be chosen according to both severity and localization of the injury, using local uninjured tissues and soft scars to make trapezoid, Z-form, triangular, free and other grafts placed on the area of the excised scars Results in 71, 05% of all cases the contracture of the foot-ankle joint was completely eliminated and the conditions necessary for the rehabilitation of the injured ankle were ensured. There was improvement after burn treatment or secondary changes due to inflammatory processes and foot inactivity due to its wrong position; in 3,95% there was not improvement. Negative results were due to deep tissue defect, irreversible changes in the bone- joints, late recourse to medical aid, and post operative effect. We did not observe any ulceration of skin grafts.

Oxy-combustion Technology Development for Fluid Catalytic Crackers (FCC) – Large Pilot Scale Demonstration

The Fluid Catalytic Cracking (FCC) process may represent as much as 30% of the total CO2 emissions from a refinery. Oxy-combustion technology is a promising option to reduce these emissions and as part of the CO2 Capture Project-Phase 3 (CCP3), Petrobras has retrofitted its large pilot scale FCC unit to demonstrate the technical viability of operating the unit in oxy-combustion conditions. The startup of the unit has shown that the transition from air to oxy is fast, however there must be a close monitoring of the excess O2 in the flue gas as it may reach low levels, taking the unit to a partial burn mode. Two extreme conditions were tested and these were called the same heat balance condition and secondly the same flow rate condition. For the same heat balance, the O2 content in the recycled gas mixture is higher and there is minimum impact on unit operational conditions and product yields. For the same flow rate, a higher overall feed conversion is observed due to a larger catalyst circulation. The oxy-combustion operation in this last condition allowed an increase of feed processing with very low changes in product slate. In all oxy tests, the CO2 content in the flue gas showed values close to 95%vol. Overall, the tests have demonstrated that it is technically viable to operate an FCC unit in the oxy-combustion mode.

Comparison of silver nylon wound dressing and silver sulfadiazine in partial burn wound therapy

The study aims to perform a comparative assessment of two types of burn wound treatment. To do the assessment, patients with partial thickness burn wounds with total body surface area <40% were simple randomised to treat with nanocrystalline silver nylon wound dressing or silver sulfadiazine cream. Efficacy of treatment, use of analgesics, number of wound dressing change, wound infection and final hospitalisation cost were evaluated. The study showed silver nylon wound dressing significantly reduced length of hospital stay, analgesic use, wound infection and inflammation compared with silver sulfadiazine.

A phase II prospective, non-comparative assessment of a new silver sodium carboxymethylcellulose (AQUACEL® Ag BURN) glove in the management of partial thickness hand burns

BackgroundNylon-reinforced silver sodium carboxymethylcellulose (AQUACEL® Ag BURN) dressings were developed to be pliable and conforming for the management of partial-thickness burns. This study evaluated the AQUACEL® Ag BURN glove for the management of hand burns. MethodsThis 21-day, phase II, prospective, non-comparative study included 23 patients with partial-thickness hand burn of at least two fingers. The AQUACEL® Ag BURN glove was applied to one hand and could remain in place up to 21 days until clinically indicated to change the glove. Dressings were evaluated 1, 2, 4, 6, 8, 14, and 21 days after initial application. Safety was the primary study endpoint. ResultsSixteen (70%) hand burns re-epithelialized fully over a mean of 15.6 days. Initial application was easy/very easy for 20 (87%) patients. Mean time for initial dressing application was 5.4min. At final evaluation, most patients gave ratings of excellent/good for conformability (91%), overall glove performance (74%), and appropriateness of sizes (83%). Mean pain score from 0 (none) to 10 (worst imaginable) was 3.43 at baseline; during the study, mean scores were 1.15 at rest and 2.29 during movement. Of 61 glove removals, most (72%) were easy/very easy, and 12% had fallen off. Adverse events (wound site or elsewhere) occurred in 15 (65%) patients. Treatment-related adverse events were wound pain (17%), maceration (9%), and stiff fingers (4%). ConclusionsThe AQUACEL® Ag BURN glove was well tolerated in the management of partial-thickness hand burn. Many patients used only one glove. When glove changes were required, they were usually quick and easy.