gms | German Medical Science

Background: Thermal injuries in children often need long term therapy and may lead to unfavorable scar formation. An effective therapy, based on the usage of wound dressing, is crucial for both superficial, partial thickness and deep, full thickness burn wounds. Wound managment aims to reduce the frequency of dressing change, prevent wound infections, promote wound-healing, and improve patient comfort. Currently, guidelines about the use of various wound dressings and combinations with antiseptic solutions are missing. This leads to individual, hospital-specific treatment standards. There are several materials on market as commonly used Suprathel®, Mepilex –Ag®, Acticoat^® and further more. Epicite hydro® is a nanocellulose based wound dressing which in our hospital is used since 2017.

Objective: The aim of this study is to evaluate the usibility and effectiveness of the bacterial nanocellulose based wound dressing, Epicite hydro®, in the treatment of burn injures in pediatric patients.

Methods: 56 patients that sustained flame, scald or contact burns in the year 2018 were treated with Epicite hydro® and were part of this study. Besides demographic data, burn degrees, and affected total body surface area, estimated by Lund and Browder chart, were collected.The observed variables in this study were the number of surgeries needed, frequency dressing changes, length of stay in hospital, complications, and need for additional treatments. A follow-up assesment of type of scar formation was performed three to six months post injury by using the Vancouver Scar Scale.

Results: Epicite hydro^® exhibited excellent adherence to the wound bed even when applied the same day of injury. The mean stay of patients (mean age 2.4 years) in hospital was 6.7 days. A significant difference between duration of hospital stay for superficial and deep burn groups was observed (p<0,05). Patients underwent dressing changes under narcosis on average 2.4 times. None of the patients had a wound-associated infection. In three cases (5.4%), extreme pain was reported. Most of the patients (80%) were treated only with Epicite hydro^® and reepithelisation occured after 10 days while the rest needed additional treatments or grafting. Patients scar assesment scores was favorable three to six months post injury. The majority of the patients had scar with normal pigmentation (98.1%), vascularisation (90.7%), height (92%) and pliability (92%).

Conclusion: Employing Epicite hydro^® as wound dressing for the treatment of both superficial, partial and deep, full thickness burn has several advantages. It is particularly easy to handle, requires a moderate number of dressing changes under narcosis and short patient hospitalisation. It has low associated infection rate and promotes wound healing. Compared with results published in literature on other wound dressing, Epicite hydro^® shows better adhesion to wound bed and decrease in overal treatment costs.