Efficacy of Allogenic Cultured Keratinocyte Grafts for Burn Wounds

Abstract Introduction Certified wound care nurses perform a vital role in skin health and management in the hospital setting. During the certification process, minimal time is spent on burn wound education, despite the fact that wound care nurses are consulted for various wound etiologies; one of those being burns. This construct created a need for collaboration between the burn team and wound care nurses. Although all burns are essentially wounds, the reality is that all wounds are not burns. The management of the burn wound is often different from the management of pressure injuries or surgical wounds. In speaking with the wound care nurses at this large urban academic medical center, a knowledge gap was identified in burn wound care education as well as appropriate and timely consultation of the burn team. Methods This knowledge improvement project focused on educating the wound care nurses in assessment and treatment of burns, and the process for burn service consultation. Burn education was provided through in-person didactic presentations. The lecture included burn wound photos with opportunities to classify the potential depth of burn wounds as well as typical complications. Additionally, it discussed when a burn consult is needed. A basic knowledge retrospective pre-posttest method was utilized. Results An educational plan was tailored to meet the learning needs of the wound care nurses to address the knowledge gap. Post test data results were tracked. Post scores were increased, indicating a successful educational intervention. Also, while providing the education, the burn outreach coordinator identified an opportunity to expand the burn center’s presence among colleagues through collaboration with the wound care nurses. The wound nurses made excellent ambassadors for the mission of the burn service. Conclusions Provision of burn education across disciplines may improve recognition of burn wounds and facilitate definitive treatment.

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Burn wounds, silver sulphadiazine and interpretations of serum Ag levels

Burns ◽

10.1016/j.burns.2020.09.013 ◽

2020 ◽

Author(s):

Subhendu Khan ◽

Jerry R. John ◽

Ramesh K. Sharma

Keyword(s):

Burn Wounds ◽

Silver Sulphadiazine

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The Impact of Simultaneous Inoculation of Pseudomonas aeruginosa, Staphylococcus aureus, and Candida albicans on Rodent Burn Wounds

Burns ◽

10.1016/j.burns.2021.02.025 ◽

2021 ◽

Author(s):

Kenneth S. Brandenburg ◽

Alan J. Weaver ◽

S.L. Rajasekhar Karna ◽

Kai P. Leung

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Candida Albicans ◽

Burn Wounds ◽

The Impact

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556 The Use of a Concentrated Surfactant Based Gel to Promote Burn Wound Healing

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.206 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S126-S127

Author(s):

Rebecca Coffey ◽

Rachel Penny

Keyword(s):

Wound Healing ◽

New Product ◽

Ease Of Use ◽

Burn Injuries ◽

Full Thickness ◽

Burn Wound ◽

Burn Wounds ◽

Burn Care ◽

Product Trial ◽

Burn Wound Healing

Abstract Introduction Strategies to remove necrotic tissue from burn wounds include excisional and non-excisional debridement. Alternative treatments could promote burn wound healing while minimizing patient discomfort and the need for surgery. We evaluated the usage of a concentrated surfactant gel (CSG) to promote burn wound healing in those with indeterminate depth and full thickness burn injuries. Methods An IRB approved retrospective study was conducted during a 10-patient new product trial period with enrollment between September and October 2019. Patients included in this study had indeterminate or full thickness burn wounds and were treated with a concentrated surfactant-based gel. Patients with non-burn diagnoses were excluded. Data collected included demographic information, injury descriptors, and additional burn wound characteristics. Results A total of 10 patients were included in this study as part of a new product trial. The subjects were 80% male with an average TBSA of 7.5%. 40% had indeterminate and 60% had full thickness burn wounds. Prior to initiation of the CSG, the burn wounds had been open for an average of 41 days. There were no infections or complications with usage of the CSG. 90% of patients reported less pain than the standard of care topical agents for burns. Average duration of treatment with the CSG until healing was 28 days. After usage of the CSG, no patients required surgery. Conclusions Our findings support the usage of a concentrated surfactant-based gel in patients with burn wounds. Patients reported decreased pain during dressing changes and ease of use compared to the standard topical agent in burn care. It also prevented surgical debridement in those with indeterminate and full thickness burn injuries.

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550 A retrospective Study of a Zinc-oxide/dimethicone for Pediatric Perineal Burn Treatment

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.200 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S123-S124

Author(s):

Waseem Diab ◽

Elika Ridelman ◽

Dawn Cloutier ◽

Lisa C Vitale ◽

Justin D Klein ◽

...

Keyword(s):

Zinc Oxide ◽

Medical Records ◽

Total Body Surface Area ◽

Healing Time ◽

Silver Sulfadiazine ◽

Control Group ◽

Post Discharge ◽

Burn Wounds ◽

Burn Center ◽

At Home

Abstract Introduction Silver-based treatments have seen widespread use for the management of burns. Recent literature, however, has demonstrated silver nanoparticles may negatively impact healing time due to its toxic effect on keratinocytes and fibroblasts at higher concentrations. At our institution, an ABA-verified pediatric burn center, the use of a silver sulfadiazine cream for management of post-discharge perineal and genital burn wounds has been replaced by a zinc-oxide/dimethicone spray-on solution initiated for its comparative ease of use. The dimethicone allows the spray to be occlusive without interfering with clothing, yet easily removed. We believed this would improve compliance with at-home treatments. Zinc-oxide’s antimicrobial activity has been demonstrated in vitro and the results from animal studies are promising for burn management. This is the first study of zinc-oxide’s efficacy as a burn management agent in humans. Our burn center’s experience with both silver sulfadiazine and zinc-oxide/dimethicone creates an opportunity to compare these products for the treatment of burn wounds. We sought to analyze the time to healing of burns treated by silver sulfadiazine against zinc-oxide/dimethicone in order to determine if zinc-oxide/dimethicone, in its easy-to-use form, is a viable alternative to silver sulfadiazine. Methods A retrospective review of medical records was conducted at a large pediatric verified burn center. Data on 98 patients was collected from the burn registry and electronic medical records. 58 patients received silver sulfadiazine while 40 received zinc-oxide/dimethicone. Four patients were removed from the silver sulfadiazine group due to incomplete data. All patients were initially treated by the burn team with follow up in burn clinic on a weekly basis until healing was achieved. Results Time to healing was significantly lower in the zinc-oxide/dimethicone intervention group (10.61 +/- .918 days) than the silver sulfadiazine control group (16.88 +/- 2.134 days). The silver sulfadiazine group contained patients with total body surface area burns significantly greater than the zinc-oxide/dimethicone group (mean: 11.57% versus 6.64%); likely due to selective treatment when zinc-oxide/dimethicone was first introduced at our facility. Differences in depth and size of burn wounds may have confound our results and negatively impacted healing time in the control group. No infection, allergic reaction, or other adverse events were noted in any patient. Conclusions Zinc-oxide/dimethicone had a significantly lower healing time than silver sulfadiazine in the treatment of at-home, post-discharge 2nd degree pediatric burns to the perineum, genitalia, suprapubis, and buttocks. Further study is needed to quantify its efficacy.

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