Healing at home: Comparing cohorts of children with medium-sized burns treated as outpatients with in-hospital applied Acticoat to those children treated as inpatients with silver sulfadiazine.

Using Acticoat (Smith & Nephew, London, UK), a dressing that requires changing only twice per week, we are able to discharge children with medium-sized burns for the majority of their acute care. In sizeable wounds, early burn care is often too painful to do at home and, therefore, sedative analgesia or anesthesia can be provided by the burn unity as necessary. In the interval between dressings, the patients remain at home. A cohort of 30 patients treated in this fashion between 2000 and 2002 were compared with 73 matched historical controls kept as inpatients and treated with silver sulfadiazine. Children treated with Acticoat spent, on average, 0.83 days admitted in hospital whereas those treated with silver sulfadiazine averaged 13.85 days (P < .001). There was a reduction in complications in patients treated with Acticoat and the need for skin grafting was not increased. We have been able to facilitate earlier discharges while continuing to provide safe and effective comprehensive burn care.