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Updated: Aug 4, 2026
Severe Burn Injury in a Swine Model for Clinical Dressing Assessment
Published on: November 6, 2018
Cost-effectiveness of silver dressings for paediatric partial thickness burns: An economic evaluation from a
E Gee Kee1, K Stockton1, R M Kimble2
1Centre for Children's Burns and Trauma Research, Child Health Research Centre, The University of Queensland, Australia.
Insights
Mepilex Ag™ is the most cost-effective dressing for paediatric partial thickness burns up to 10% TBSA. This study found it cheaper and more effective than Acticoat™ and Acticoat™ with Mepitel™, making it the recommended choice.
Area of Science:
- Paediatric burn management
- Wound healing
- Health economics
Background:
- Partial thickness burns up to 10% TBSA are common in children.
- Current treatments often use expensive silver dressings.
- Economic evaluations are needed to guide dressing selection.
Purpose of the Study:
- To conduct a cost-effectiveness analysis of three silver dressings for paediatric partial thickness burns (≤10% TBSA).
- To compare Acticoat™, Acticoat™ with Mepitel™, and Mepilex Ag™.
- To use days to full wound re-epithelialization as the primary health outcome.
Main Methods:
- Trial-based economic evaluation from a healthcare provider perspective.
- Included 96 children aged 0-15 years with partial thickness burns ≤10% TBSA.
- Collected costs related to dressing, labor, analgesics, and scar management.
Main Results:
- Mepilex Ag™ had significantly lower costs (median AUD$94.45) compared to Acticoat™ ($244.90) and Acticoat™ with Mepitel™ ($196.66).
- Mepilex Ag™ demonstrated a 99% and 97% probability of dominating Acticoat™ and Acticoat™ with Mepitel™, respectively.
- Sensitivity analyses confirmed Mepilex Ag™ as the dominant choice.
Conclusions:
- Mepilex Ag™ is the dominant and recommended dressing for paediatric partial thickness burns ≤10% TBSA.
- This economic evaluation supports Mepilex Ag™ over Acticoat™ and Acticoat™ with Mepitel™.
- The findings provide valuable economic data for healthcare providers managing paediatric burns.
Background:
Partial thickness burns of up to 10% total body surface area (TBSA) in children are common injuries primarily treated in the outpatient setting using expensive silver-containing dressings. However, economic evaluations in the paediatric burns population are lacking to assist healthcare providers when choosing which dressing to use. The aim of this study was to conduct a cost-effectiveness analysis of three silver dressings for partial thickness burns ≤10% TBSA in children aged 0-15 years using days to full wound re-epithelialization as the health outcome.
Method:
This study was a trial based economic evaluation (incremental cost effectiveness) conducted from a healthcare provider perspective. Ninety-six children participated in the trial investigating Acticoat™, Acticoat™ with Mepitel™ or Mepilex Ag™. Costs directly related to the management of partial thickness burns ≤10% TBSA were collected during the trial from March 2013 to July 2014 and for a one year after re-epithelialization time horizon. Incremental cost effectiveness ratios were estimated and dominance probabilities calculated from bootstrap resampling trial data. Sensitivity analyses were conducted to examine the potential effect of accounting for infrequent, but high cost, skin grafting surgical procedures.
Results:
Costs (dressing, labour, analgesics, scar management) were considerably lower in the Mepilex Ag™ group (median AUD$94.45) compared to the Acticoat™ (median $244.90) and Acticoat™ with Mepitel™ (median $196.66) interventions. There was a 99% and 97% probability that Mepilex Ag™ dominated (cheaper and more effective than) Acticoat™ and Acticoat™ with Mepitel™, respectively. This pattern of dominance was consistent across raw cost and effects, after a priori adjustments, and sensitivity analyses. There was an 82% probability that Acticoat™ with Mepitel dominated Acticoat™ in the primary analysis, although this probability was sensitive to the effect of skin graft procedures.
Conclusion:
This economic evaluation has demonstrated that Mepilex Ag™ was the dominant dressing choice over both Acticoat™ and Acticoat™ with Mepitel™ in this trial-based economic evaluation and is recommended for treatment of paediatric partial thickness burns ≤10% TBSA.
