October 20, 2010 (San Francisco, California) — In children with partial-thickness burns, the Biobrane wound dressing product (Smith & Nephew, Hull, United Kingdom) reduced healing time, compared with beta-glucan collagen (BGC), according to research presented here at the American Academy of Pediatrics 2010 National Conference and Exhibition.
Biobrane is a biosynthetic wound dressing constructed of a silicone film, with a nylon fabric partially imbedded into the film.
In 2003, after many years of using BGC, the researchers' burn unit decided to switch to Biobrane. "BGC is also a good product, but it's much less versatile, harder to put on, and ultimately it's harder to tell when the burn is healed and the dressing should come off," Aaron Lesher, MD, general surgery resident at the Medical University of South Carolina in Charleston, who presented the research, told Medscape Medical News.
The team conducted a retrospective chart review of all children treated in the pediatric burn program between January 2003 and May 2009. In all, 291 patients were treated with Biobrane for partial-thickness burns. Using age, burn mechanism, and percent of body surface area burned, 43 patients were matched with patients from a previous study that involved patients with partial-thickness burns treated with BGC. The researchers used the Wilcoxon signed-rank test to compare length of hospital stay, number of outpatient visits, and days to heal.
The team compiled complete data on 217 patients treated with Biobrane (mean age, 5.8 years; range, 4 weeks to 18 years). The average total body surface area of the burn was 6% (range, 1% to 30%). Average hospital stay was 2.6 days (range, 0 to 41 days), and there was an average of 3 follow-up outpatient visits (range, 1 to 13 visits). The median number of days to healing was 9 (range, 5 to 60 days), and about 45% of patients were seen on an outpatient-only basis.
Patients in the BGC group had larger burns, on average, than those in the Biobrane group (body surface area, 9.3% vs 6.0%; P = .0008), but there was no significant difference in the number of outpatient visits or the number of patients treated on an outpatient basis. There was no statistically significant difference in the length of hospital stay, but days to heal was shorter in the Biobrane group (median, 9 days; range,1 to 37 days) than in the BGC group (median, 13 days; range, 1 to 43 days; P = .019, Cox proportional hazards model).
The researchers also found a hazard ratio of 1.68 for Biobrane vs BGC, "which means that a patient with a Biobrane dressing who has not yet healed by a certain day had 1.68 times the chance of being healed by the next day, compared with someone in the BGC group," Dr. Lesher said during his presentation.
"I think BGC is very good at treating donor sites for split-thickness skin grafts. It's also very good for long flat surfaces, because it becomes thick and rigid, not pliable like Biobrane. But when children get burned on their feet, on their hands, or on their bottoms, none of these are good places for BCG because they're not flat," Dr. Lesher told Medscape Medical News.
Ultimately, it's important to choose a product and continue to use it, especially in academic centers where personnel come and go, said Dr. Lesher. "You need to have one that works well, is easy to apply, and is easy for parents to take care of at home. We chose Biobrane and we'll certainly stick with it because it's worked very well for our program."
"I think it showed promising results as far as . . . a new outpatient modality for partial thickness burns. There are certain concerns. Long-term studies need to be done for functional cosmetic outcomes, but the data are very promising as a novel way to manage partial-thickness burns," Eugene Kim, MD, a pediatric surgeon at Texas Children's Hospital in Houston, who moderated the session, told Medscape Medical News.
The study did not receive commercial support. Dr. Lesher and Dr. Kim have disclosed no relevant financial relationships.
American Academy of Pediatrics (AAP) 2010 National Conference and Exhibition: Abstract 9239. Presented October 2, 2010.
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Cite this: Biobrane Silicone-Embedded Mesh Reduces Healing Time in Partial-Thickness Burns - Medscape - Oct 20, 2010.