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Clinical evaluation of a PHMB-impregnated biocellulose dressing on paediatric lacerations
G Elzinga1, J van Doorn, A M Wiersema
1Emergency Department and Wound Healing Centre, Bovenlj Hospital, Amsterdam, The Natherlands.
Insights
A new PHMB-impregnated biosynthetic cellulose dressing significantly reduced pain and infection in pediatric heel lacerations. This child and parent-friendly dressing promotes good healing outcomes and is now a standard treatment.
Area of Science:
- Wound healing
- Pediatric trauma care
- Antimicrobial dressings
Background:
- Pediatric heel lacerations from bicycle accidents often lead to infection.
- Conventional treatments require frequent dressing changes, causing distress.
- A novel approach using a PHMB-impregnated dressing was evaluated.
Purpose of the Study:
- To assess the clinical benefits of a PHMB-impregnated biosynthetic cellulose dressing for pediatric heel lacerations.
- To evaluate dressing tolerability, pain reduction, and healing efficacy.
- To determine the incidence of infection and patient satisfaction.
Main Methods:
- A prospective clinical evaluation of 20 children with heel lacerations.
- Application of a PHMB-impregnated biocellulose dressing, left in situ until epithelialization.
- Use of a cork splint for 3 days to immobilize the ankle.
- Assessment of wound size, infection, wound bed characteristics, and pain (0-10 scale) every 3 days for 14 days.
Main Results:
- Mean wound closure time was 12.95 days.
- Mean pain score decreased from 9.55 to 0.15 by day 14 (p<0.003).
- 17 out of 20 children were pain-free after 3 days; no local infections were reported.
Conclusions:
- The PHMB-impregnated dressing is child and parent-friendly.
- The dressing demonstrated good tolerability and effective wound healing.
- This dressing has been integrated into the standard treatment protocol for these injuries.
Objective:
To evaluate the clinical benefits, primarily tolerability and reduction in pain levels, associated with the use of a PHMB-impregnated biosynthetic cellulose dressing (Suprasorb X + PHMB) on paediatric heel lacerations.
Method:
These lacerations were caused when children, who were being transported on their parents' bicycles, got their heels trapped in the wheel spokes. Where these injuries just comprised skin contusion and laceration, treatment had previously comprised cleansing followed by application of conventional dressings and moist wound healing dressings. However, the high incidence of infection necessitated regular dressing changes, which caused parents and children stress and anxiety. This clinical evaluation assessed the benefits of a new treatment protocol, where the PHMB-impregnated biocellulose dressing was applied and left in situ until epithelialisation occurred. A cork splint was used for 3 days to prevent pes equinus and to let the ankle joint rest. Change in wound size (cm²), incidence of local infection, wound bed characteristics and pain levels (measured on a 0-10 paediatric pain scale) were assessed at 3-day intervals during the 14-day treatment period. Satisfaction with the dressing was also evaluated.
Results:
Twenty children (mean age 5.6 years (± 1.33) were recruited into the study and included in the analysis. The mean baseline wound area was 8.60cm² (± 6.57). The mean time to complete wound closure was 12.95 days (± 7.69) with a mean total of 4.70 visits (± 1.56). The mean VAS pain score was 9.55 (± 0.69), compared with 0.15 (± 0.37) on day 14 (p<0.003). At the second visit (after 3 days) 17 of the 20 children were reported to be free of pain. No cases of local infection were noted.
Conclusion:
The dressing was found to be child and parent friendly. The evaluation also showed that it was well tolerated and achieved good healing outcome. It has now been incorporated into the clinic's treatment protocol for these wounds.
Conflict Of Interest:
None. The authors have no relevant financial interest in this article. All authors were involved in the critical revision of the manuscript for important intellectual content.
