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Enzo Osti, MD

Arch Surg. 2006;141:39-42.

Hypothesis  A transparent adhesive film possessing selective permeability combined with a hydrogel (Burnshield) may be effective in burn patients to reduce skin maceration, improve medication, control pain more effectively, and reduce the incidence of late complications (hypertrophic scars).

Design  This is a prospective study; the mean follow-up in all patients was 28.4 months (range, 14-35 months). The external part of the film is impermeable to fluid and microorganisms, but allows transpiration of water vapor from the cutis. The permeability to water vapor of a semipermeable film in contact with liquids is measured in grams per meters squared every 24 hours at 37°C, and is defined as the moisture vapor transmission rate. In this study, a film with a moisture vapor transmission rate of 1600 g/m² every 24 hours at 37°C was used.

Patients  For about 2 years, this type of therapy was used in the first aid treatment of 48 burn patients, 4 of whom were lost during therapy and 4 of whom were unavailable for follow-up.

Interventions  The patients were treated with hydrogel and a semipermeable film at first medication, and some were treated in this way during subsequent medications.

Main Outcome Measures  The mean reepithelialization time of all patients was 17 days (range, 4-60 days); 8 (20%) of 40 patients with complications were treated with a gel (Same Plast Gel). Late complications were observed: hypertrophic scars in 2 patients (5%) and dyschromic lesions in 6 (15%).

Results  The most frequent complication, which occurred at various stages during medication, was skin maceration (15 [34%] of 44 patients). Other complications recorded during therapy were infections in 2 patients (5%), vertigo in 1 patient (2%), and abundant fibrin production in 1 patient (2%). In some of the patients, associated diseases and/or conditions were found: hepatic cirrhosis, diabetes mellitus, epilepsy, and pregnancy (33rd week) (each found in 1 patient each). Four patients were sent to the burn unit, 3 with second-degree burns of the hand and 1 with first-/second-degree burns of the abdomen and thigh, with 12% of the total body surface area burned.

Conclusions  In the reepithelialization phase, complications were recorded in 8 of the 40 patients: 7 (18%) had residual inflammation and 1 (2%) had a hypertrophic scar. During the follow-up, late complications were recorded in 2 (5%) of the 40 patients. A gel was used in 8 patients: in 6 of the 7 patients with residual inflammation, the complication resolved, while in 1, despite therapy, the residual inflammation evolved into hypertrophic scarring. Treatment with the gel in the 2 patients with late lesions reduced the thickness and extent of the lesions, with minimal aesthetic and functional damage.

Author Affiliation: Emergency Department, San Donà di Piave, Venice, Italy.

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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Notice of Duplicate Publication in: Cutaneous Burns Treated With Hydrogel (Burnshield) and a Semipermeable Adhesive Film
Arch Surg 2006;141:1146-1146.
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