SURGICAL OUTCOME OF SECOND-DEGREE BURNS IN PAEDIATRIC PATIENTS: ANTIBIOTIC COATED DRESSING & SPLIT SKIN GRAFTING
Abstract
INTRODUCTION Burn injury is a form of acute trauma with very unique presentation, associated prognostic factors, complications and methods of treatment. Children are one of the most commonly affected age group who are usually caught in house fires and accidental situations leading to serious morbidity and a considerable mortality.
OBJECTIVE To determine the outcome of burns in paediatric age patients for antibiotic coated dressing and split skin grafting.
METHODS This is a retrospective review of prospectively collected data of paediatric age patients treated at Habib Burns Centre, Peshawar, Pakistan between January 2013 and December 2015. Data analysed included patient demographics, burn characteristics (burn type, body surface area, time to presentation and culture positivity of wound surface), treatment methods with either dressing and debridement only or split skin grafting, in terms of total healing time, length of hospital stay and mortality.
RESULTS Total 1777 no of paediatric patients with mean age of 10 years ±3.42 SD. The mean total body surface area (TBSA) was 18.16% ± 8.59 SD for the dressing and debridement group while it was 31.78% ± 10.74 SD for the grafting group. Mean healing time for the dressing and debridement group was 14.41 days ± 5.75 SD while it was 25.76 days ± 7.13 SD for the grafting group. Mean length of stay (LOS) for dressing group was 8.13 days ± 3.66 SD and it was 13.82 days ± 6.51 SD for the grafting group. There was a significant difference between the two treatment groups for total healing time (mean difference: -11.35, 95% CI; -11.988 to -10.71; p < 0.001, t (1175.2) = -34.81) and total length of stay (mean difference: -5.67, 95% CI; -6.24 to -5.16; p < 0.001, t (918.2) = -20.68).A positive correlation (r2 = 0.49) was noted between TBSA and total healing time (p < 0.001) as well as TBSA and total length of stay (r2 = 0.69, p < 0.001).
CONCLUSION Coating with a mixture of antibiotic and silver ointments followed by covering the wound antibiotic impregnated dressing mesh gives superior results in partial thickness burn wounds. It should be employed as a measure for those patients who present late or cannot afford urgent grafting.
KEY WORDS Burns. Paediatric, Outcome, Dressing technique, Grafting
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