Treatment of Partial Thickness Burns: A Prospective, Randomized Controlled Trial Comparing Four Routinely Used Burns Dressings in an Ambulatory Care Setting

摘要

This prospective, randomized controlled trial study compared the effects of four dressings for adult partial thickness burns, focusing on re-epithelialization time and cost effectiveness. Adults with partial thickness burns meeting inclusion criteria were randomized to either Biobrane (TM), Acticoat (TM), Mepilex (R) Ag, or Aquacel (R) Ag. Primary endpoint for analysis was >95 re-epithelialization. Incremental cost-effectiveness ratios were calculated based on dressing costs. Dominance probabilities between treatment arms were calculated from bootstrap resampling trial data. One hunderd thirty-one partial thickness burn wounds in 119 patients were randomized. Adjusting for sex, age, smoking status, burn mechanism, TBSA, and first aid adequacy, Mepilex (R) Ag had a reduced time to re-epithelialization compared to Biobrane (TM) (IRR: 1.26; 95 CI: 1.07-1.48, P < .01). Economic analysis showed that there was a 99, 71, and 53 probability that Mepilex (R) Ag dominated (cheaper and more effective) Biobrane (TM), Acticoat (TM), and Aquacel (R) Ag, respectively. Mepilex (R) Ag achieved faster re-epithelialization and better cost effectiveness. Patient satisfaction and comfort seems better with Biobrane (TM) although not reflected within the end outcome of the healed wound. It is the patients' (after extensive education) and clinicians' choice, level of experience, and availability of products in praxis that will guide the decision as to which the product is used individually on which patient.