isons of the Effects of Biological Membrane (Amnion) and Silver Sulfadiazine in the Management of Burn Wounds in Children
Prospective study conducted on 102 children with 2nd degree burns to assess the difference between silver sulfadiazine and oven-dried, radiation-sterilized human amnion as wound dressing
- Normally, burns are treated with Silver Sulfadiazine bid or as required after cleaning the wound with normal saline or sterile water—however dressings are laborious, time consuming, and require skill
- Patients also feel pain during SD dressing and between dressing; Additionally SD application is expensive and can cause neutropenia
- 90 years ago, application of amniotic membrane was first suggested as a biological skin substitute or dressing for burn wounds
- It was speculated that human amniotic membrane might be more comfortable and less painful; thus superior to SD
Method:
- This randomized prospective study was conducted on burn patients admitted to the burn unit of the Pediatric Surgery Ward in the Sher-e-Bangla Medical college hospital in Bangladesh between April 2006 and June 2007
- Variables studied included:
- Number of days stayed in hospital
- Number of dressing changes
- Time needed for epithelization
- Expression and activity of the children
- In-between application to assess pain
- Assessment of activities
- How the patient and guardian accepted treatment
- Opinions of the attending doctor toward method of treatment
- 102 patients included in this study and they were randomly divided irrespective of age and sex in groups receiving either topical silver SD or AM.
- All patients having second and third degree burns also received prophylactic antibiotics consisting of single dose of IM benzathine penicillin
Discussion: The results of this study showed that there was a reduction in hospital stay after use of radiation-sterilized, oven-dried AM as a dressing for partial thickness burn injuries, also observed in another study
- This may be because AM prevents oozing of plasma, early drying of wounds, and acts as a barrier
- The main difference between two modalities of treatment was the use of often single dressing with AM compared with the repeated painful cleaning and reapplication of the silver SD
- Use of AM offered best compliance to the attending doctor, patients, and guardians
- Application was less traumatic and less laborious
- Because the application of the radiation sterilized, oven-dried AM is convenient for the clinician and comfortable for the patient, it is well accepted by patients and guardians.
- CONCERN: There is still a concern related to the possibility of transmitting disease, including HIV
