Shanks Lindsay A, Cronshaw Andrea, Alexander K Skaria, Davies Jonathan A, O'Boyle Ciaran P
Department of Paediatric Burns and Plastic Surgery, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Medical School, University of Nottingham, Nottingham, UK.
Scars Burn Heal. 2020 Aug 11;6:2059513120940503. doi: 10.1177/2059513120940503. eCollection 2020 Jan-Dec.
EpiProtect® is a biosynthetic cellulose dressing indicated for the treatment of superficial burns and the dressing of deep burns. Prior to this study the youngest reported patient treated with EpiProtect® was aged 13 years.
Data were collected prospectively for patients aged < 5 years, presenting to the Children's Burns Unit with ⩾ 2% total body surface area (TBSA) burns sustained by any mechanism.
Thirty children were treated (median age = 17 months, age range = 1-61 months). Thirty-six burn depths were documented: superficial partial thickness (SPT) in 53% (n=19); mid-partial thickness (MPT) in 33% (n=12); deep partial thickness (DPT) in 11% (n=4); and full thickness (FT) in 3% (n=1). Median burn size was 4.5% TBSA (range = 2%-12%). EpiProtect® was applied under general anaesthesia in all cases. The median length of stay (LOS) was two days (range = 0-6 days). EpiProtect® was tolerated well and provided effective analgesia for subsequent dressing changes. Median healing time was 13 days (SPT burns), 14 days (MPT) and 24 days (DPT burns). Three patients required split skin grafting. Hypertrophic scarring arose in one patient.
This case series represents the youngest published patient group to have been treated with EpiProtect®. Authors conclude that EpiProtect® provides a safe, reliable and well-tolerated dressing option for all burn depths in young children. Importantly, EpiProtect® is culturally neutral and may be used in situations which, for cultural reasons, may preclude the use of animal-derived products. Further studies are warranted to evaluate pain scores, burn depth, size and LOS correlation, and comparative analysis between dressing types.
Burn injuries in the paediatric population are common and often require multiple dressing changes. Dressing changes can be painful and distressing to both children and their care givers. This article describes the experience of using a synthetically derived burns dressing, called EpiProtect®, in children aged ⩽ 5 years. Thirty patients were recruited with varying depths of scald burns and all underwent application of EpiProtect® dressing. The results suggested that EpiProtect® was a user-friendly dressing that can be used to treat partial-thickness burns and to dress full-thickness (FT) burns. It was well-tolerated and provided effective analgesia at the time of dressing changes. There was no incidence of increased burn wound infection rates and all wounds healed. In addition, as EpiProtect® is a synthetic product, it has the benefit of being culturally neutral, which is advantageous in a culturally diverse population. Further studies are warranted to evaluate the effectiveness of this dressing and to compare it to similar dressings that are available.
EpiProtect®是一种生物合成纤维素敷料，适用于浅表烧伤的治疗以及深度烧伤的包扎。在本研究之前，报道中使用EpiProtect®治疗的最年轻患者为13岁。
前瞻性收集年龄＜5岁、因任何机制导致全身表面积（TBSA）烧伤≥2%并前往儿童烧伤科就诊的患者的数据。
共治疗30名儿童（中位年龄 = 17个月，年龄范围 = 1 - 61个月）。记录了36处烧伤深度：浅表部分厚度（SPT）占53%（n = 19）；中间部分厚度（MPT）占33%（n = 12）；深部部分厚度（DPT）占11%（n = 4）；全层厚度（FT）占3%（n = 1）。中位烧伤面积为4.5% TBSA（范围 = 2% - 12%）。所有病例均在全身麻醉下应用EpiProtect®。中位住院时间（LOS）为2天（范围 = 0 - 6天）。EpiProtect®耐受性良好，为后续换药提供了有效的镇痛效果。中位愈合时间为13天（SPT烧伤）、14天（MPT）和24天（DPT烧伤）。3例患者需要进行自体皮移植。1例患者出现增生性瘢痕。
该病例系列代表了已发表的接受EpiProtect®治疗的最年轻患者群体。作者得出结论，EpiProtect®为幼儿各种深度的烧伤提供了一种安全、可靠且耐受性良好的敷料选择。重要的是，EpiProtect®在文化上是中立的，可用于因文化原因可能排除使用动物源性产品的情况。有必要进一步开展研究以评估疼痛评分、烧伤深度、面积和住院时间的相关性，以及不同敷料类型之间的对比分析。
儿科人群中的烧伤很常见，通常需要多次换药。换药对儿童及其护理人员来说可能既痛苦又令人苦恼。本文描述了在5岁及以下儿童中使用一种合成来源的烧伤敷料EpiProtect®的经验。招募了30例不同深度烫伤的患者，均接受了EpiProtect®敷料的应用。结果表明，EpiProtect®是一种使用方便的敷料，可用于治疗部分厚度烧伤和包扎全层厚度（FT）烧伤。它耐受性良好，在换药时提供了有效的镇痛效果。烧伤创面感染率没有增加，所有伤口均愈合。此外，由于EpiProtect®是一种合成产品，它在文化上是中立的，这在文化多元的人群中具有优势。有必要进一步开展研究以评估这种敷料的有效性，并将其与现有的类似敷料进行比较。
