Reduction in skin grafting after the introduction of hydrofiber dressings in partial thickness burns: A comparison between a hydrofiber and silver sulphadiazine

Aim/purpose

The aim of this study was to compare clinical outcome of children with scald burns treated with a hydrofiber dressing (Aquacel^®, Convatec Inc.) with the former standard of care with silver sulfadiazine (Flammazine^®; Solvay Pharmaceuticals), considering surgical intervention and length of stay (LOS).

Methods

A retrospective study of all consecutive children from zero to four years with primary scald burns up to 10% admitted to the Burn Centre of the Maasstad Hospital Rotterdam between January 1987 and January 2010 were reviewed. For data collection a prospective computerized database was used. For comparison the study period was divided into two periods representing the period before and after the introduction of the hydrofiber dressing (HFD), respectively 1987–1999 (period 1) and 1999–2010 (period 2).

Results

Over the whole study period 27.3% of 502 patients treated with silver sulfadiazine (Ag-SD) underwent surgery, while before the introduction of HFD 30.5% of 338 Ag-SD treated patients were operated upon. After the introduction of the HFD 20.7% of 164 patients treated with Ag-SD eventually underwent skin grafting, a significant difference with the 11.6% of 302 patients whose wounds were dressed with HFD (p < 0.01).

Conclusions

Compared to silver sulfadiazine treatment a reduced number of surgical interventions was observed in mixed partial thickness scald burns up to 10% TBSA burned in children aged 0–4 years after the introduction of hydrofiber dressings. The mode of treatment with this wound dressing also limited hospital length of stay.