The use of Biobrane for coverage of the pediatric donor site

Donor site dressings are highly diverse. The ultimate goal of any coverage is to minimize pain and healing time. Recently, synthetic laminates have become popular. Experience with Biobrane has mainly been with adult patients. This study examines the use of Biobrane in a pediatric population. One hundred eight consecutive applications of Biobrane in 95 patients (mean age 7.9 years) were reviewed. All applications were treated in identical fashion. Biobrane was left in place until healing occurred unless primary nonadherence occurred or fluid collections developed over a significant area, rendering the area nonadherent. Forty-three early removals of Biobrane were necessary at a mean of 3 1/2 days after application. The back and hip regions, with 43% and 80% early removal rates, respectively, were the areas where Biobrane was least successful in providing donor coverage until the site healed. The chest and thigh had successful full-term coverage in greater than 90% of cases. The principal basis for early removal was fluid accumulation, which reduced adherence. Early removal did not affect the healing time of the donor site. These results demonstrate a modest effectiveness of Biobrane as a donor site dressing on the back and hip regions in pediatric patients with burns. Selection of sites for which good success can be expected should be paramount in the decision to use this donor site material in this patient population.