According to the French recommendations, superficial second degree burns must be handled with a type B, C, D bandages, with a control at day 8. And according to two Cochrane meta-analysis in 2013, the use of silver sulfadiazine is associated with a significant increase of infections, of the duration of hospitalizations and with a worse healing. Silver sulfadiazine should be excluded and replaced by hydrogel bandages, which seem to improve the healing.
Methodology
We conducted a review of second degree burn records over three year (2016-2018), following the publication of a new management protocol in our ER. The elements collected were age, sex, cause, the affected site, cooling before dressing, pain level at day 0 and day 1, tetanus vaccinal status, type of dressing, reassessments.
Results
We recorded 185 patients, aged 1 – 87, 57% women. The main causes were boiling water and oil, no site predominated. Tetanus vaccination status was known in 31%. Only 45% were cooled before or in the ER. A hydrogel HYDROTAC transparent dressing (type B) was used in 72%, silver sulfadiazine in 11%, and trolamine emulsion in 9%.
In terms of follow-up, there was 55% of reassessment at day 1, 14% at day 8. And 8 patients were immediately referred to burn center, 8 others after reassessment.
Patients treated with hydrogel HYDROTAC transparent dressings had a pain decrease in pain between day 0 (medium level 5 [0 – 10]) and day 1 (medium level 2 [0 – 7]), while there was no decrease for those treated with silver sulfadiazine between day 0 (medium level 5 [2-7]) and day 1 (medium level 5 [5-5]).
Conclusion
The establishment of a management protocol haves enabled our ER to share and clarify the objectives of superficial cutaneous burns care. The hydrogel HYDROTAC transparent dressing seems effective to reach the goals ofsuperficial cutaneous burn care.
This abstract has been presented on LINK Wound Healing Congress 2019
