Dr Dharshini Selvarajah1, Dr Bapesh Krishna Bollu1, Professor John Harvey1, Dr Susan Jehangir1, Ms Claire Toose1, Professor Andrew Holland1, Ms Madelene Jacques1
1The Children’s Hospital Westmead, Westmead, Australia
Purpose:Scalds involving toddlers commonly involve the torso and are frequently mid-dermal in depth. Initial management of a mid-dermal burn is conservative, progressing to grafting if healing has not been achieved in 10-14 days. Biobrane has been reported as having a more favourable outcome compared to Acticoat. The Burns Unit at the Children’s Hospital at Westmead (CHW) uses both dressings on a regular basis, providing the opportunity to compare the results of the dressings in a cohort of patients with mid-dermal burns of the torso.
Methods:A retrospective review was undertaken of all paediatric mid-dermal torso burns admitted to CHW between 2015 and 2016. Patients requiring grafts for full-thickness burns or with other dressings were excluded. The primary outcomes were: time to complete healing and the need for grafting. Secondary outcomes included: operating theatre time, clinic visits, length of stay in hospital, scar outcomes and cost.
Results:Eight-one of the 124 children reviewed met the study criteria; 64 (79%) were treated with Acticoat and 17 (21%) with Biobrane. In total, 27/64 (42%) children in the Acticoat group and 11/17 (58%) children in the Biobrane group healed without grafting (p= 0.27). There was no difference between the groups in healing time, or scar outcome. Patients treated with Biobrane required longer operating time, a longer hospital stay and more clinic visits.
Conclusion: This study suggests that Biobrane does not significantly improve the outcome of mid-dermal torso burns in children compared to Acticoat, but appears to be more time consuming and expensive.
Dr Dharshini Selvarajah- burns registrar from The Children’s Hospital Westmead NSW