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Updated: Dec 10, 2025

Severe Burn Injury in a Swine Model for Clinical Dressing Assessment
Published on: November 6, 2018
Evaluation of EpiProtect® microbial cellulose burns dressings in young children
Lindsay A Shanks1, Andrea Cronshaw1, K Skaria Alexander1,2
1Department of Paediatric Burns and Plastic Surgery, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Insights
EpiProtect® dressing is safe and effective for treating burns in children under five years old. This biosynthetic cellulose dressing offers good pain relief and healing for various burn depths.
Area of Science:
- Pediatric Burn Care
- Wound Healing Dressings
- Biomaterials in Medicine
Background:
- Paediatric burn injuries are prevalent and necessitate frequent, often painful, dressing changes.
- EpiProtect® is a biosynthetic cellulose dressing approved for superficial and deep burns.
- Previous studies on EpiProtect® involved patients aged 13 years and older.
Purpose of the Study:
- To evaluate the safety and efficacy of EpiProtect® in children under five years old.
- To assess EpiProtect®'s performance across different burn depths and sizes in young patients.
- To determine EpiProtect®'s suitability as a culturally neutral dressing option.
Main Methods:
- Prospective data collection from patients under five years with burns covering at least 2% of total body surface area (TBSA).
- Thirty children were treated with EpiProtect® under general anaesthesia.
- Burn depths, TBSA, length of stay (LOS), healing times, and adverse events were documented.
Main Results:
- Thirty children (median age 17 months) with burns ranging from 2% to 12% TBSA were treated.
- EpiProtect® was effective for superficial partial thickness (SPT), mid-partial thickness (MPT), and deep partial thickness (DPT) burns.
- Median healing times were 13 days (SPT), 14 days (MPT), and 24 days (DPT); LOS was a median of two days.
- The dressing was well-tolerated, provided analgesia, and resulted in minimal scarring.
Conclusions:
- This study includes the youngest patients treated with EpiProtect®, demonstrating its safety and effectiveness in children under five.
- EpiProtect® is a reliable, well-tolerated dressing for all burn depths in young children.
- Its synthetic and culturally neutral nature makes it suitable for diverse populations.
Introduction:
EpiProtect® is a biosynthetic cellulose dressing indicated for the treatment of superficial burns and the dressing of deep burns. Prior to this study the youngest reported patient treated with EpiProtect® was aged 13 years.
Method:
Data were collected prospectively for patients aged < 5 years, presenting to the Children's Burns Unit with ⩾ 2% total body surface area (TBSA) burns sustained by any mechanism.
Results:
Thirty children were treated (median age = 17 months, age range = 1-61 months). Thirty-six burn depths were documented: superficial partial thickness (SPT) in 53% (n=19); mid-partial thickness (MPT) in 33% (n=12); deep partial thickness (DPT) in 11% (n=4); and full thickness (FT) in 3% (n=1). Median burn size was 4.5% TBSA (range = 2%-12%). EpiProtect® was applied under general anaesthesia in all cases. The median length of stay (LOS) was two days (range = 0-6 days). EpiProtect® was tolerated well and provided effective analgesia for subsequent dressing changes. Median healing time was 13 days (SPT burns), 14 days (MPT) and 24 days (DPT burns). Three patients required split skin grafting. Hypertrophic scarring arose in one patient.
Discussion:
This case series represents the youngest published patient group to have been treated with EpiProtect®. Authors conclude that EpiProtect® provides a safe, reliable and well-tolerated dressing option for all burn depths in young children. Importantly, EpiProtect® is culturally neutral and may be used in situations which, for cultural reasons, may preclude the use of animal-derived products. Further studies are warranted to evaluate pain scores, burn depth, size and LOS correlation, and comparative analysis between dressing types.
Lay Summary:
Burn injuries in the paediatric population are common and often require multiple dressing changes. Dressing changes can be painful and distressing to both children and their care givers. This article describes the experience of using a synthetically derived burns dressing, called EpiProtect®, in children aged ⩽ 5 years. Thirty patients were recruited with varying depths of scald burns and all underwent application of EpiProtect® dressing. The results suggested that EpiProtect® was a user-friendly dressing that can be used to treat partial-thickness burns and to dress full-thickness (FT) burns. It was well-tolerated and provided effective analgesia at the time of dressing changes. There was no incidence of increased burn wound infection rates and all wounds healed. In addition, as EpiProtect® is a synthetic product, it has the benefit of being culturally neutral, which is advantageous in a culturally diverse population. Further studies are warranted to evaluate the effectiveness of this dressing and to compare it to similar dressings that are available.
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