Comparative Efficacy of Cultivated Epidermal Allograft and Hydrocolloid Dressings in Pediatric Burn Injuries

TL;DR

This study compares two burn treatments in children, finding that cultivated epidermal allografts heal faster and reduce the need for skin grafts compared to hydrocolloid dressings.

Contribution

The study introduces evidence that cultivated epidermal allografts are more effective than hydrocolloid dressings in treating pediatric burn injuries.

Findings

Patients treated with cultivated epidermal allografts had faster epithelialization (8 days) compared to hydrocolloid dressings (18 days).

Only 19% of the allograft group required skin grafting, versus 50% in the hydrocolloid group.

The allograft group had shorter hospital stays (7 days) compared to the hydrocolloid group (10.5 days).

Abstract

Introduction: Managing burns in pediatric patients is crucial due to their unique physiology and higher risk of complications compared to adults. Key components of burn management for pediatric patients involve assessing the extent of the burn injury, administering appropriate pain management, and closely monitoring for signs of infection. Comprehensive burn management includes securing an adequate airway, administering appropriate anesthesia, performing surgical debridement, repairing damaged regions with skin grafts, providing nutritional support, and facilitating rehabilitation for optimal recovery. Dressing-based therapy is essential in comprehensive burn care, as it promotes wound healing, prevents infection, reduces pain during dressing changes, and maintains a moist wound environment for optimal recovery. Ideal dressings should promote wound healing, possess antibacterial properties, minimize discomfort during changes, and effectively alleviate pain. A study was conducted to evaluate the effectiveness of treating pediatric burn wounds using cultivated epidermal allografts compared to hydrocolloid dressings, aiming to assess the necessity for skin grafting and identify potential complications.

Methods: A retrospective cross-sectional study was conducted on pediatric patients with burn injuries. The analyzed variables included age, sex, burn mechanism, percentage of total body surface area (TBSA) affected, anatomical site, burn depth, length of hospital stay, type of dressing used, time to complete epithelialization, need for skin grafting, admission to the intensive care unit (ICU), and mortality. Patients were categorized into two groups: those treated with cultivated epidermal allografts and those treated with hydrocolloid dressings. Inferential statistical analyses were performed to assess the association between the type of treatment and the necessity for skin grafting.

Results: A total of 65 patients were included. The most common age group was preschoolers (1-5 years) , with a median age of three years, representing 64% of cases. Males were more affected. Scalds were the most frequent burn mechanism (64%; n=42). The median TBSA affected was 8%, and second-degree burns (both superficial and deep) were the most prevalent (55%). The trunk was the most affected area. In the cultivated epidermal allograft group, the median time to epithelialization was eight days, and the median hospital stay was seven days. In contrast, the hydrocolloid group had a median epithelialization time of 18 days and a median hospital stay of 10.5 days. Only 19% (n=4) of patients in the cultivated epidermal allograft group required skin grafting, compared to 50% (n=11) in the hydrocolloid group (p=0.016).

Conclusion: Cultivated epidermal allograft showed a tendency towards being beneficial for managing partial-thickness and indeterminate-depth burns, promoting faster epithelialization, preventing burn progression, and reducing the need for skin grafts. Its use was also associated with shorter hospital stays and potentially lower healthcare costs.

Figures