Improvement in trauma care depends on the establishment of functioning trauma care systems, of which a trauma registry is a crucial component. Hospitals and governments in developing countries should be encouraged to establish trauma registries using proven cost-effective strategies.

Patients with TBI from NAT have increased morbidity and mortality compared with patients with TBI from accidental mechanisms; these differences are present at all levels of severity of injury. Patients with TBI from NAT represent a vulnerable group of pediatric trauma patients who are at increased risk for death and worse outcome and who will require greater short- and long-term medical resources.

We sought to study whether the application of a novel silver impregnated antimicrobial dressing (Aquacel Ag, ConvaTec, Princeton, NJ) affects the hospital length of stay in pediatric patients with partial-thickness burns. A retrospective review of Burn Registry Data from a large children's hospital burn unit was conducted to answer this question. Pediatric patients admitted with partial-thickness burns treated with Aquacel Ag from January 2005 through August 2005 were included in the study (n = 39). The comparison group of patients treated with silver sulfadiazine (SSD; Par Pharmeceuticals, Woodcliff, NJ) cream was matched for age and %TBSA burned from the same time period the previous year (n = 40). Analysis was conducted for intent to treat. Mean length of stay for control patients treated with SSD was significantly longer (8.36 days) compared with Aquacel Ag-treated patients (4.48 days; p = .002, t-test for unequal variances). Length of stay for both groups was significantly associated with %TBSA burned (p < .001, r2 = .38). Post-hoc analysis controlling for %TBSA burned revealed an adjusted mean length of stay for the control group that was longer than that of the Aquacel Ag group (5.9 days vs. 3.8 days, respectively). These data confirm that application of a new burn dressing (Aquacel Ag) reduces hospital length of stay. Reduction in the complexity and number of dressing changes needed with use of Aquacel Ag, in combination with significantly reduced length of stay, should result in a significant cost savings in the care of this patient population.