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Treatment of Children With Scalds by Xenografts: Report From a Swedish Burn Centre
Moustafa Elmasry1, Ingrid Steinvall, Johan Thorfinn
1From the *The Burn Centre, Department of Hand Surgery, Plastic Surgery, and Burns, †The Burn Centre, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; ‡Plastic Surgery Unit, Surgery Department, Suez Canal University, Ismailia, Egypt; and §The Burn Centre, Department of Anaesthesiology and Intensive Care, Linköping University, Linköping, Sweden.
Insights
Xenografts without topical antimicrobials effectively treated pediatric scalds, showing low infection rates and pain. This method is linked to shorter hospital stays relative to burn size.
Area of Science:
- Pediatric Burn Care
- Wound Healing
- Dermatology
Background:
- Scalds are the most common burn type in children.
- Xenografts without topical antimicrobials are recommended but lack detailed examination.
- Understanding this treatment's efficacy and outcomes is crucial for pediatric burn management.
Purpose of the Study:
- To describe the treatment outcomes of pediatric scalds managed with xenografts.
- To evaluate the use of biological dressings (xenografts) without local antimicrobials.
- To assess infection rates, pain scores, and hospital stay duration.
Main Methods:
- Retrospective review of medical records of children treated with xenografts for scalds.
- Data collected included burn size (TBSA%), age, hospital stay, operations, antibiotic use, and pain scores (FLACC).
- Study period: 2010-2012 at a Swedish National Burn Centre.
Main Results:
- 67 children (median age 1 year, median TBSA% 6.2) were studied.
- 18% developed wound infections; 43% had other infections.
- Treatment was associated with short hospital stays (median 0.7 days/TBSA%) and low pain scores (FLACC < 3 for most).
Conclusions:
- Xenograft treatment without topical antimicrobials is effective for pediatric scalds.
- The treatment is linked to favorable outcomes, including reduced hospital stay and pain.
- Systemic antibiotics were frequently prescribed but often for non-wound-related infections.
Abstract:
Scalds are the most common type of burn in children, and one way to treat them is with xenografts with no topical antimicrobials in line with the recommendations of a recent review. However, this treatment has not been examined in detail. Our aim was to describe the treatment of such children when biological dressings (xenografts) were used without local antimicrobials. We reviewed the medical records of all children admitted to a Swedish National Burn Centre during the period 2010-2012 with scalds who were treated with xenografts. Percentage TBSA injured, age, length of hospital stay, number of operations, antibiotics given, duration of antibiotic treatment, and pain score during the first 3 days, application of xenografts, and clinical notes of wound infection were recorded. We studied 67 children, (43 of whom were boys), with a median (interquartile range [IQR]) age of 1 (1-2) year and median (IQR) TBSA% 6.2 (4-11). Twenty children (30%) required operation. Twelve (18%) developed a wound infection, 29 (43%) had other infections, and 26 (39%) were free from infection. The median (IQR) duration of systemic antibiotics was 10 (6-13) days. On the day that the xenografts were applied 10 of the children had a Face, Legs, Activity, Cry, and Consolability (FLACC) score between 3 and 7, and during the following 2 days, only four children scored in this range. The remaining 57 children had scores < 3 on the day that xenografts were applied and on the following 2 days. Median (IQR) length of stay/TBSA% was 0.7 (0.4-1.0). Treatment with xenografts was associated with median length of stay/TBSA% <1 and low pain scores. Despite a high rate of prescription of systemic antibiotics, most were for reasons other than wound infection.
