Newer Dressing Improves Burn Care

From the American Burn Association

LAS VEGAS—Newer dressings are improving the care of patients with partial-thickness burns, said Daniel M. Caruso, MD, chairman, Department of Surgery, and medical director, Arizona Burn Center, Maricopa Medical Center, Phoenix, at the annual meeting of the American Burn Association.

In a study presented at the meeting, a nonwoven Hydrofiber dressing with silver (Aquacel Ag) required fewer dressing changes and fewer procedural medications, compared with silver sulfadiazine 1% cream, resulting in lower total treatment costs in adult and pediatric patients with partial-thickness burns.

In a second study presented at the meeting, the dressing reduced hospital length of stay of pediatric patients by more than one third compared with silver sulfadiazine (3.8 vs 5.9 days, respectively).

Although silver sulfadiazine has been the gold standard for treating partial-thickness burns, dressings using this cream need to be changed at least once a day, and the treatment is associated with pain.

"Once the dressing hardens and sticks, there are no more dressing changes." ?Daniel M. Caruso, MD

The newer Hydrofiber dressing has a 1.2% ionic silver reservoir inside the fibers, providing microbicidal activity against aerobic and anaerobic bacteria, yeasts, and filamentous fungi, said Dr Caruso.

The new dressing absorbs 20 to 25 times its weight, enabling it to be used on highly exuding wounds. It is nonadherent and removes easily.

The first study included 82 patients aged 6 months to 80.6 years with partial-thickness burns on 5% to 40% of total body surface area. Patients were randomized to a protocol of care that included either the Hydrofiber dressing or silver sulfadiazine.

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Fewer types of procedural medications were required in patients who received the Hydrofiber dressing (2.4 vs 3.4; = .018), as well as fewer opiates (1.5 vs 2.1; = .022).

Dressing changes were less frequent in the patients randomized to the Aquacel dressing. “Once the dressing hardens and sticks, there are no more dressing changes,” said Dr Caruso.

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The mean total number of dressing changes was 7.7 in patients treated with the Hydrofiber dressing versus 19.1 in the silver sulfadiazine group ( <.001).

Changing burn dressings often causes trauma and anxiety for the patient, he noted. Advanced dressings that support safe and effective healing, require fewer changes, and provide greater patient comfort should advance the standard of care, reduce hospital days and total costs of care, and lesson patient anxiety and pain.