Journal Article

418 A Comparison of Antibiotic Ointment vs. A Silver-based Dressing for Children with Upper Extremity Burns: a Randomized Controlled Study

Y Choi, J Recicar and S Moulton

in Journal of Burn Care & Research

Volume 39, issue suppl_1, pages S181-S181
Published in print April 2018 | ISSN: 1559-047X
Published online April 2018 | e-ISSN: 1559-0488 | DOI: http://dx.doi.org/10.1093/jbcr/iry006.340
418 A Comparison of Antibiotic Ointment vs. A Silver-based Dressing for Children with Upper Extremity Burns: a Randomized Controlled Study

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  • Medicine and Health
  • Acute Medicine
  • Emergency Medicine
  • Critical Care
  • Surgery

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Abstract

Introduction

Antibiotic or silver-impregnated dressings are widely used in burn wound care. Our standard method of dressing pediatric upper extremity burn wounds consists of a primary antibiotic ointment or Nystatin ointment-impregnated non-adherent gauze layer, followed by rolled gauze, cast pad, plaster and soft casting material. The aim of this study was to compare two different primary dressing layers in the management of pediatric upper extremity burns: ointment vs. an active silver-based dressing, keeping all the other dressing layers the same.

Methods

Children ≤ 18 years old with upper extremity burns who would be managed with our soft casting technique, between September 2016 and September 2017, were eligible for enrollment in the study. Burn depth was assessed by two providers. Subjects were then randomized and placed into our primary ointment-based dressing (control) or the primary silver-based dressing (intervention). The primary layer was secured with our soft cast dressing. Dressings were changed twice-weekly or weekly until the burn wound was healed or grafted. The primary outcome was time to re-epithelization of the wound. P-value <0.05 was considered significant.

Results

A total of 76 children with burns to 91 upper extremities were enrolled in the study. In the intention to treat analysis, time to re-epithelization was significantly shorter in the control group (12 ± 4 vs 15 ± 6 days; P=0.03). There were no differences in the incidences of grafting (5% vs 4%; P=0.73) or yeast infections between the two groups (8% vs 9%; P=0.8).

Conclusions

This study shows that antibiotic or Nystatin ointment-impregnated dressings are more effective at burn wound healing than silver-based dressings when combined with our soft casting technique.

Applicability of Research to Practice

Standard antibiotic or Nystatin ointment-impregnated dressings are more effective at burn wound healing than silver-based dressings for management of upper extremity burns in children.

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Subjects: Medicine and Health ; Acute Medicine ; Emergency Medicine ; Critical Care ; Surgery

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