Burns
Conditions
Keywords
hand, burns, thermal, dressing, Aquacel®, Mepilex® Transfer Ag, Xeroform®, Bacitracin®, partial thickness, epithelialization, wound healing, scar, scarring
Brief summary
Specific Aim 1: To determine if one of three burn dressings provides a less painful healing experience for partial thickness hand. Specific Aim 2: To evaluate if one of three dressings provides greater functionality during and after healing of partial thickness hand burns. Specific Aim 3: To determine if one of three burn dressings promotes aesthetically superior healing results for partial thickness hand burns.
Detailed description
Various products are on the market and available for use on partial thickness burns to the hand/s. Our current institutional standard of care is to use Xeroform Gauze (Coviden, Mansfield, MA) and Bacitracin Ointment (Fougera, Melville, NY) to promote a moist antibacterial healing environment with the ability to monitor the healing progress daily. However, silver (AG) based dressings that employ nanocrystalline technology with hydrofiber (Aquacel AG burn; ConvaTec, Princeton, NJ) or soft silicone foam (Mepilex AG ; Molnlycke Health Care, Dunstable, United Kingdom) have been well accepted as alternative dressing solutions. These dressings have longer interval times between changes, leading to a reported increase in patient comfort, diminished skin shearing/stripping, and rapid re-epithelialization. Given the anatomic intricacies, partial thickness burns to the hand present a challenge in dressing selection. Recently, ConvaTec unveiled the Aquacel AG Burn Glove for use on partial thickness hand burns. In line with this idea, our institution has now begun to fashion a novel burn glove out of Mepilex Transfer AG with good success. To date there are no known studies that compare Xeroform/Bacitracin, Aquacel AG burn glove or Mepilex Transfer AG dressing. The goal of this study is to compare these three burn dressings used to treat partial-thickness hand burns and their impact on pain, function, and aesthetic outcomes. We will also explore psychosocial issues related to hand burn dressing changes.
Interventions
OTHERAquacel® Ag Burn Glove
burn dressing
OTHERMepilex® Transfer Ag
burn dressing
DRUGantibiotic
antibiotic burn dressing
Sponsors
Southern Illinois University
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
8 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Patients presenting at Memorial Medical or Southern Illinois University (SIU) Health Care * Patients with partial-thickness burn injuries to the dorsum and/or palm of the hand/s that exceeds ½% total body surface area (TBSA) for at least one hand. * \< 10% TBSA 2nd and 3rd degree burn injuries * Initial clinical presentation \< 5 days post burn injury
Exclusion criteria
* \< ½ % TBSA involving the hand * \> 10%TBSA burn injuries * \> 60 years of age * \< 8 years of age * Patients (or parents of minors) without cognitive capacity to comprehend informed consent * Presentation \> 5 days post-burn injury event * Pregnant women * Full thickness/3rd degree burns to the dorsal and/or palmer hand/s * Exposed vital structures (tendons, nerves, bone, vessels) * Uncontrolled Type II Diabetes * Type I Diabetes * History of Chronic Obstructive Pulmonary Disease * Have a known allergy to silver products * Signs of infection on initial clinical presentation (presence of purulent drainage, significant cellulitis, and/or fever) * Smoke/inhalation injuries requiring ventilation * Critically ill patients requiring intensive care
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| pain | baseline to 6 months post-burn injury | pain as measured by the Patient and Provider Scar Assessment Scale |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| pain | baseline to 6 months post-burn injury | pain as measured by the Michigan Hand Outcomes Questionnaire (MHQ) |
| functionality | baseline to 6 months post-burn injury | functionality as measured by the Michigan Hand Outcomes Questionnaire (MHQ) |
| aesthetic appearance | baseline to 6 months post-burn injury | scar formation and aesthetic appearance measured using the Vancouver Scar Scale |
Other
| Measure | Time frame | Description |
|---|---|---|
| quality of life | baseline to 6 months post-burn injury | quality of life measured by the psychosocial scales: Burn Specific Health Scale (BSHS) |
| resilience | baseline to 6 months post-burn injury | resilience measured by the Connor-Davidson Resilience Scale (CD-RISC) |
Countries
United States
Outcome results
None listed