Biobrane versus topical agents in the treatment of adult scald burns

Nicco Krezdorn; Sören Könneker; Felix Julian Paprottka; Christian Tapking; Tobias R Mett; G Felix Brölsch; Maria Boyce; Ramin Ipaktchi; Peter M Vogt

doi:10.1016/j.burns.2016.07.022

Biobrane versus topical agents in the treatment of adult scald burns

Burns. 2017 Feb;43(1):195-199. doi: 10.1016/j.burns.2016.07.022. Epub 2016 Aug 7.

Authors

Nicco Krezdorn¹, Sören Könneker², Felix Julian Paprottka³, Christian Tapking⁴, Tobias R Mett², G Felix Brölsch², Maria Boyce², Ramin Ipaktchi², Peter M Vogt²

Affiliations

¹ Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: krezdorn.nicco@mh-hannover.de.
² Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
³ Department of Plastic Surgery and Hand Surgery, AGAPLESION Diakonieklinikum Rotenburg, Elise-Averdieck-Straße 17, 27356 Rotenburg (Wümme), Germany.
⁴ Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.

PMID: 27507189
DOI: 10.1016/j.burns.2016.07.022

Abstract

Background: Limited data is available for treatment of scald lesions in adults. The use of the biosynthetic matrix Biobrane^® has been suggested as treatment option with more benefits over topical dressings. Application of Biobrane^® in scalds in our center led to a perceived increase of infection, secondary deepening, surgery and length of stay. We therefore assessed the effect of different treatment options in adult scalds in our center.

Methods: We performed a retrospective cohort study of adult patients that have been admitted with scalds in our center between 2011 and 2014. We assessed two groups, group 1 with Biobrane^® as initial treatment and group 2 with topical treatment using polyhexanid hydrogel and fatty gauze. Primary outcome variables were rate of secondary deepening, surgery, infection (defined as positive microbiological swabs and antibiotic treatment) and length of stay. Total body surface area (TBSA) as well as diabetes mellitus (DM), hypertension, smoking and alcohol consumption as potential confounders were included.

Results: A total of 52 patients were included in this study. 36 patients received treatment with Biobrane^® and 16 with ointment and fatty gauze. No significant differences were found for age and TBSA whereas gender ratio was different (25/11 male/female in group 1 vs 4/12 in group 2, p=0.003). Rate of secondary deepening, surgery, infection as well as days of hospital stay (DOHS) were comparable. Logistic and multilinear regression showed TBSA to be a predictive factor for infection (p=0.041), and TBSA and age for length of stay (age p=0.036; TBSA p=0.042) in group 1.

Conclusion: The use of Biobrane^® in adult scald lesions is safe and non-inferior to topical treatment options. In elder patients and larger TBSA Biobrane^® may increase the risk of infection or a prolonged stay in hospital.

Level of evidence: Level 3 - retrospective cohort study.

Keywords: Adult scald; Biobrane; Burn wound infection; Scald lesion; Scald treatment.

Publication types

Comparative Study

MeSH terms

Administration, Cutaneous
Adult
Age Factors
Aged
Alcohol Drinking / epidemiology
Biguanides / therapeutic use*
Body Surface Area
Burns / epidemiology
Burns / therapy*
Coated Materials, Biocompatible / therapeutic use*
Comorbidity
Diabetes Mellitus / epidemiology
Disinfectants / therapeutic use*
Female
Humans
Hypertension / epidemiology
Length of Stay / statistics & numerical data*
Male
Middle Aged
Occlusive Dressings*
Retrospective Studies
Smoking / epidemiology
Trauma Severity Indices
Wound Infection / epidemiology*

Substances

Biguanides
Biobrane
Coated Materials, Biocompatible
Disinfectants
polihexanide