Abstract
Introduction
This prospective, randomised controlled trial study compared the effects of four dressings for adult partial thickness burns, focusing on re-epithelialisation time and cost-effectiveness.
Methods
Adults with partial thickness burns meeting inclusion criteria were randomised to either Biobrane™, Acticoat™, Mepilex® Ag or Aquacel® Ag. Primary endpoint for analysis was >95% re-epithelialisation. Incremental cost effectiveness ratios were calculated based on dressing costs. Dominance probabilities between treatment arms were calculated from bootstrap resampling trial data.
Results
131 partial thickness burn wounds in 119 patients were randomised. Adjusting for gender, age, smoking status, burn mechanism, TBSA, and first aid adequacy, Mepilex® Ag had a reduced time to re-epithelialisation compared to Biobrane™ (IRR 1.26; 95% CI: 1.07 – 1.48, P < 0.01). Economic analysis showed that there was a 99%, 71% and 53% probability that Mepilex® Ag dominated (cheaper and more effective) Biobrane™, Acticoat™ and Aquacel® Ag, respectively.
Conclusions
Mepilex® Ag achieved faster re-epithelialisation and better cost effectiveness. Patient satisfaction and comfort seems better with Biobrane™ although not reflected within the end outcome of the healed wound. It is the patients’ (after extensive education) and clinicians’ choice, level of experience and availability of products in praxis that will guide the decision as to which product is used individually on which patient.