Effectiveness of a hydrogel dressing as an analgesic adjunct to first aid for the treatment of acute paediatric burn injuries: a prospective randomised controlled trial

Holbert, Maleea; Kimble, Roy; Chatfield, Mark D.; Griffin, Bronwyn

doi:10.1136/bmjopen-2020-039981

Cited by 14 publications

(5 citation statements)

References 37 publications

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“…During cooling with hydrogels, the obtained temperature is about 20.5 °C on the surface of the wound, whereas at a depth of 1–3 mm it is about 33 °C [ 14 ]. What is more, these products provide an analgesic effect and can be safely used as a first aid dressing even in pediatric patients [ 22 ] ( Figure 3 ). The water content in hydrogels is important in cooling, as water stabilizes the temperature of the wound.…”

Section: Burn Wound Coolingmentioning

confidence: 99%

Hydrogels in Burn Wound Management—A Review

Surowiecka¹,

Strużyna

Winiarska³

et al. 2022

Gels

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Inert hydrogels are of a great importance in burn first aid. Hydrogel dressings may be an alternative to cooling burn wounds with streaming water, especially in cases of mass casualty events, lack of clean water, hypothermia, or large extent of burns. Hydrogels that contain mostly water evacuate the heat cumulating in the skin by evaporation. They not only cool the burn wound, but also reduce pain and protect the wound area from contamination and further injuries. Hydrogels are ideally used during the first hours after injury, but as they do not have antimicrobial properties per se, they might not prevent wound infection. The hydrogel matrix enables incorporating active substances into the dressing. The active forms may contain ammonium salts, nanocrystal silver, zinc, growth factor, cytokines, or cells, as well as natural agents, such as honey or herbs. Active dressings may have antimicrobial activity or stimulate wound healing. Numerous experiments on animal models proved their safety and efficiency. Hydrogels are a new dressing type that are still in development.

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Section: Burn Wound Coolingmentioning

confidence: 99%

Hydrogels in Burn Wound Management—A Review

Surowiecka¹,

Strużyna

Winiarska³

et al. 2022

Gels

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“…Previous acute paediatric burn RCTs have shown that theoretical frameworks for feasibility are often unachievable 6 15–18. Given the specificity of the type of burn (burns that conform to a PICO dressing), it is likely that eligible participants form a small sub cohort.…”

Section: Methodsmentioning

confidence: 99%

Protocol for a feasibility, acceptability and safety study of the PICO device (negative pressure wound therapy) in acute paediatric burns

et al. 2023

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IntroductionNegative pressure wound therapy (NPWT) in acute burn care may decrease the time to re-epithelialisation by more than 20%. Despite this, the perceived burden of use; including therapeutic, physical and financial, have limited the use of NPWT in acute burn care. This might be minimised by using the small, ultraportable, single-use NPWT device PICO as opposed to larger devices, which to date has never been studied in acute burn care. This research will; therefore, primarily assess the feasibility, acceptability and safety of PICO in paediatric burns. Secondary outcomes include time to re-epithelialisation, pain, itch, cost and scar formation.Methods and analysisThis protocol details a clinical trial methodology and is pre-results. This single site, prospective, pilot randomised controlled trial will be conducted in an Australian quaternary paediatric burns centre. Participants must be aged ≤16 years, otherwise well and managed within 24 hours of sustaining a burn that fits beneath a PICO dressing. Thirty participants will be randomised to one of three groups: group A: Mepitel and ACTICOAT, group B: Mepitel, ACTICOAT and PICO and group C: Mepitel, ACTICOAT Flex and PICO. Patient outcomes will be recorded at each dressing change to assess efficacy and safety outcomes until 3 months postburn wound re-epithelialisation. Surveys, randomisation and data storage will be undertaken via online platforms and physical data storage collated at the Centre for Children’s Health Research, Brisbane, Australia. Analysis will be done by using StataSE 17.0 statistical software.Ethics and disseminationEthics has been obtained from Queensland Health and Griffith Human Research Ethics committees including a site-specific approval. These data will be disseminated via clinical meetings, conference presentations and peer-reviewed journals.Trial registration numberACTRN12622000009718.

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“…Previous acute paediatric burn RCTs have shown that theoretical frameworks for feasibility are often unachievable (27,(29)(30)(31)(32). Given the speci city of the type of burn (signi cant hand and/or foot burns), it is likely that eligible participants will form a small subcohort.…”

Section: Outcomes Pilot Trial Primary Outcomesmentioning

confidence: 99%

The feasibility of Negative Pressure Wound Therapy versus Standard Dressings in Paediatric Hand and Foot Burns Protocol: A Pilot, Single-Centre, Randomised Control Trial

Lumsden

Kimble

McMillan

et al. 2022

Preprint

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Introduction: The goal of paediatric hand and foot burn management is hypertrophic scar and/or contracture prevention. The risk of scar formation may be minimised by integrating Negative Pressure Wound Therapy (NPWT) as an acute care adjunct as it decreases the time to re-epithelialisation. NPWT has known associated therapeutic burden; however, this burden is hypothesised to be outweighed by an increased likelihood of hypertrophic scar prevention. This study will assess the feasibility, acceptability and safety of NPWT in paediatric hand and foot burns with secondary outcomes of time to re-epithelialisation, pain, itch, cost and scar formation. Methods and analysis: This is a single site, pilot randomised control trial. Participants must be aged ≤16-years, otherwise well and managed within 24hours of sustaining either a hand or foot burn. Thirty participants will be randomised to either standard care (Mepitel® – a silicone wound interface contact dressing – and ACTICOAT™ – a nanocrystalline silver-impregnated dressing) or standard care plus NPWT. Patients will be reviewed until three months post burn wound re-epithelialisation, with measurements taken at dressing changes to assess primary and secondary outcomes. Surveys, randomisation and data storage will be done via online platforms and physical data storage collated at the Centre for Children’s Health Research, Brisbane, Australia. Analysis will be performed using Stata statistical software. Ethics and Dissemination: Queensland Health and Griffith University Human Research ethics approval including a site-specific assessment was obtained. The findings of this study will be disseminated through clinical meetings, conference presentations and peer reviewed journals. Registration and Details: Registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12622000044729, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381890&isReview=true, registered 17/01/2022).

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Effectiveness of a hydrogel dressing as an analgesic adjunct to first aid for the treatment of acute paediatric burn injuries: a prospective randomised controlled trial

Cited by 14 publications

References 37 publications

Hydrogels in Burn Wound Management—A Review

Hydrogels in Burn Wound Management—A Review

Protocol for a feasibility, acceptability and safety study of the PICO device (negative pressure wound therapy) in acute paediatric burns

The feasibility of Negative Pressure Wound Therapy versus Standard Dressings in Paediatric Hand and Foot Burns Protocol: A Pilot, Single-Centre, Randomised Control Trial

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