Comparisons of the Effects of Biological Membrane (Amnion) and Silver Sulfadiazine in the Management of Burn Wounds in Children

Abstract

This prospective study was conducted on 102 children with second-degree thermal burns to assess qualitative differences between topical silver sulfadiazine (SD) and oven-dried, radiation-sterilized human amnion as wound dressing. The patients were divided into silver SD and amniotic membrane (AM) group by random sampling technique. The variables compared 1) the number of days admitted in the hospital, 2) the number of dressing changes, 3) time needed for epithelialization, 4) comfort and pain of the patients during dressing, 5) comfort and pain of the patients between dressings, 6) activities during treatment, 7) acceptability of the modules by the patients or attending guardians, and 8) comfort of the doctor during application. Patients' ages ranging from 1 day to 12 years and admitted to inpatient burn unit within 72 hours of occurrence were included in this study. Fifty-one burned children enrolled in each group. The mean hospital stay is significantly lower in AM group (P < .01). The number of dressing changes in AM group was significantly low (P < .001). The mean time taken for epithelial coverage of superficial second-degree burns is significantly lower in AM than in SD group (P < .001) and also those of deep second-degree burns (P < .001). Application was painless in AM than SD group (P < .001). State of pain in-between application shows significant difference (P < .001). Application of AM was comfortable to the attending doctor (P < .001). Significant activity of the patients was observed during treatment (P < .01) with AM. AM was accepted by the patients or parents (P < .001). This study indicates that radiation-sterilized, oven-dried AM is a better treatment option because its use reduces hospital stay and the number of dressing changes. Epithelialization of the wound is quicker. The use of AM is painless and odorless. The procedure is easy and comfortable to the doctor, and it is well accepted. Most of the patients remain ambulatory during treatment.

Usability and effectiveness of Suprathel® in partial thickness burns in children

“…The number of outer layer dressing changes is not previously described in studies in patients with partial thickness burns that were treated with Suprathel ® . The number of outer layer dressing changes in our study is comparable with the mean number of dressing changes between 1.5 and 7.5 in RCTs that used (semi)synthetics dressings in the treatment of partial thickness burns in children [23, 24, 44, 45]. …”

Maximizing the safety of glycerol preserved human amniotic membrane as a biological dressing

“…It was proved better than antimicrobial dressings and some synthetic dressings in many aspects of wound care [16,18,30]. On the other hand, Biobrane witch is a synthetic biological dressing, had comparable effects with HAM; however, preserved human skin was the most effective [11].…”

“…The proven properties of HAM as a biological temporary dressing include promotion of epithelialization and wound healing due its content of growth factors [12,13] along with analgesic effects [14][15][16]. Dressing of burns with HAM limits fluid and protein loss which reflects on general patient's outcome [17,18].…”

Silver-based dressings for the reduction of surgical site infection: Review of current experience and recommendation for future studies

“…This paper focused on the uses of silver in postoperative dressings to reduce SSI rates. Other uses of silver include the management of traumatic wounds, ulcers, ophthalmic conditions, and, most commonly, the treatment of burns [11][12][13]61,76,77,[84][85][86][87][88][89][90][91].…”