Mrs Herni Lutfiah Hussein1, Mrs Nurazlin Azman1, Ms Joanne Jovina SH Cheng1
1Kk Women’s And Children’s Hospital, Sengkang, Singapore
Background:KK Women’s and Children’s Hospital is the referring paediatric hospital in Singapore for a wide variation of burns. The Department of Plastic, Reconstructive and Aesthetic Surgery consults an average of 23 paediatric burns a month, of which facial burns is common and a challenging area for dressing coverage.
Keragel is a thick hydrogel consisting of keratin protein which provides a moisture rich environment. It delivers Replicine™ Functional Keratin® which aids in epithelialisation of a wound. Application of Keragel is advise to apply twice a day to cover the entire wound surface without the need for dressing coverage.
Biobrane is a biosynthetic dressing extract from porcine dermal collagen secured to a silicone membrane. Application of Biobrane requires a sterile environment in the operating theatre as the dressing need to be secured with stitches/staples or securement tapes.
Aim:The aim of this case series is to evaluate the healing rate of using Keragel or Biobrane on pediatric facial burn. The cost of care and pain management will be explore too.
Method: Retrospective data of 4 paediatric patients with partial to deep partial thickness burns to the face were selected. All patients are within the age group of >6months of age to 16 years of age. 2 patients had application of Keragel dressing on their burns while the other 2 patients had Biobrane dressing.
Conclusion: Keragel took an average of 7-14 days to heal completely, while Biobrane dressing took more than 7 days of expected healing time as it converted to deeper burns. The cost of care on Keragel was reduced as it can be managed in an outpatient setting whereas Biobrane dressing required admission for application in the operating theatre. There was also reduce pain experienced in Keragel application as it is easy to clean and re-apply with minimal pain. As compared to Biobrane dressing, the removal of stitches/staples or securement tapes is done in the clinic with pre-medications given.
Keragel is easy to use by parents at the home settings as it does not require hospital admission. It minimizes trauma and requires less visit to the clinic for dressing change.
I have been working for 14 years in KK Women’s and Children’s Hospital. I worked in a surgical ward for 7 years before transferring out to the Department of Plastic Reconstructive and Aesthetics Surgery. I am a nurse clinician and WOCN nurse too. I worked in an outpatient setting where burns cases is one of the common wound dressing I do in my daily job.