Abstract
Introduction
Burn injury is one of the most common reasons for admission in paediatric population. There is currently no international consensus on the best wound dressing material. Aquacel Ag, a new silver containing hydrofiber dressing material has been reported to produce good clinical results. Yet, only a limited number of studies exist in the paediatric population. This study aims to review our experience of burn management over the past 5 years and to evaluate the effectiveness of Aquacel Ag in the management of partial thickness burns.
Methods
A retrospective review of all patients admitted for burn injury between January 2010 and December 2014 was conducted. Patients’ demographics, mechanism of injury, body surface areas involved, treatment applied, and clinical outcomes were analyzed. Patients with superficial injury, full thickness burns that required surgical debridement, burn area less than 2 % or more than 25 % of total body surface area, or incomplete clinical data were excluded from the comparative study.
Results
A total of 119 patients were identified. 114 (96 %) was due to domestic injury, of which 108 (91 %) was food-related. The most commonly affected areas were limbs (n = 89, 74.8 %), followed by trunk (n = 62, 74.8). 84 patients fulfilled the inclusion criteria and were recruited into the study. 31 patients received Aquacel Ag dressing and 53 patients received standard paraffin gauze dressing. The two groups showed no statistical difference in age, sex, percentage of total body surface area involved, and infection rate. Outcomes of patients treated with Aquacel Ag were compared with patients treated with standard dressing. The mean hospital stay was significantly shorter for the Aquacel Ag group (14.26 vs 23.45, p = 0.045). Aquacel Ag group required much less frequent dressing change (5.67 vs 20.59, p = 0.002). 5 patients in standard dressing group developed hypertrophic scar and required prolonged pressure garment, whereas only one hypertrophic scar was observed in the Aquacel Ag group.
Conclusion
Aquacel Ag appears to promote early burn wound healing with less hypertrophic scar formation.
Similar content being viewed by others
References
Cheng W, Saing H, Zhou H et al (2001) Ultrasound assessment of scald scars in Asian children receiving pressure garment therapy. J Pediatr Surg 36:466–469
Gonzalez R, Shanti CM (2015) Overview of current pediatric burn care. Semin Pediatr Surg 24:47–49
Barnea Y, Weiss J, Gur E (2010) A review of the applications of the hydrofiber dressing with silver (Aquacel Ag) in wound care. Ther Clin Risk Manag 6:21–27
Bowler PG, Jones SA, Walker M et al (2004) Microbicidal properties of a silver-containing hydrofiber dressing against a variety of burn wound pathogens. J Burn Care Rehabil 25:192–196
Castellano JJ, Shafii SM, Ko F et al (2007) Comparative evaluation of silver-containing antimicrobial dressings and drugs. Int Wound J 4:114–122
Paddock HN, Fabia R, Giles S et al (2007) A silver impregnated antimicrobial dressing reduces hospital length of stay for pediatric patients with burns. J Burn Care Res Off Publ Am Burn Assoc 28:409–411
Saba SC, Tsai R, Glat P (2009) Clinical evaluation comparing the efficacy of aquacel ag hydrofiber dressing versus petrolatum gauze with antibiotic ointment in partial-thickness burns in a pediatric burn center. J Burn Care Res Off Publ Am Burn Assoc 30:380–385
Brown M, Dalziel SR, Herd E, et al (2015) A randomized controlled study of silver-based burns dressing in a pediatric emergency department. J Burn Care Res. doi:10.1097/BCR.0000000000000273
Caruso DM, Foster KN, Blome-Eberwein SA et al (2006) Randomized clinical study of Hydrofiber dressing with silver or silver sulfadiazine in the management of partial-thickness burns. J Burn Care Res Off Publ Am Burn Assoc 27:298–309
Jurczak F, Dugre T, Johnstone A et al (2007) Randomised clinical trial of Hydrofiber dressing with silver versus povidone-iodine gauze in the management of open surgical and traumatic wounds. Int Wound J 4:66–76
Jude EB, Apelqvist J, Spraul M et al (2007) Prospective randomized controlled study of hydrofiber dressing containing ionic silver or calcium alginate dressings in non-ischaemic diabetic foot ulcers. Diabet Med J Br Diabet Assoc 24:280–288
Waring MJ, Parsons D (2001) Physico-chemical characterisation of carboxymethylated spun cellulose fibres. Biomaterials 22:903–912
Barnea Y, Amir A, Leshem D et al (2004) Clinical comparative study of aquacel and paraffin gauze dressing for split-skin donor site treatment. Ann Plast Surg 53:132–136
Moyer CA (1965) Some effects of 0.5 per cent silver nitrate and high humidity upon the illness associated with large burns. J Natl Med Assoc 57:95–100
Lansdown AB (2002) Silver. I: its antibacterial properties and mechanism of action. J Wound Care 11:125–130
Percival SL, Bowler PG, Russell D (2005) Bacterial resistance to silver in wound care. J Hosp Infect 60:1–7
Lohana P, Potokar TS (2006) Aquacel ag(R) in paediatric burns—a prospective audit. Ann Burns Fire Disasters 19:144–147
Paddock HN, Fabia R, Giles S et al (2007) A silver-impregnated antimicrobial dressing reduces hospital costs for pediatric burn patients. J Pediatr Surg 42:211–213
Yates CC, Whaley D, Babu R et al (2007) The effect of multifunctional polymer-based gels on wound healing in full thickness bacteria-contaminated mouse skin wound models. Biomaterials 28:3977–3986
Tian J, Wong KK, Ho CM et al (2007) Topical delivery of silver nanoparticles promotes wound healing. ChemMedChem 2:129–136
Wong KK, Cheung SO, Huang L et al (2009) Further evidence of the anti-inflammatory effects of silver nanoparticles. ChemMedChem 4:1129–1135
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflicts of interest to declare.
Rights and permissions
About this article
Cite this article
Lau, C.T., Wong, K.K.Y. & Tam, P. Silver containing hydrofiber dressing promotes wound healing in paediatric patients with partial thickness burns. Pediatr Surg Int 32, 577–581 (2016). https://doi.org/10.1007/s00383-016-3895-0
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-016-3895-0