Annals of Burns and Fire Disasters (ISSN 1592-9566) - Pending Publications

AN ALTERNATIVE FOR LOCAL TREATMENT OF SUPERFICIAL BURNS

Enescu D., Bratu T., Berechet-Comanescu P., Ionita D.

Children’s Emergency Hospital, Grigore Plastic and Reconstructive Department, Bucharest, Rumania

SUMMARY. There is a wide variety of local therapeutical methods for partial superficial burns. Burns require meticulous local treatment as part of the complex therapeutic protocol. Local treatment for burns is essential, influencing the patient’s evolution and future. All local burn treatment methods are adapted in relation to the particular aspects of the burn lesion (patient’s age, aetiology, localization, associated pathologies). Immerci H3 was clinically tested for partial superficial burns treatment and the results were favourable. Healing was more rapid and there was a decrease in mean hospital stay and treatment costs.

Introduction

Burns are the greatest trauma a human being can encounter, the greatest medical and surgical emergency. In Romania approximately 12000 adults and 5000 children are admitted to hospital with burns every year. The number treated as out-patients is even greater. Children’s burns account for some 40% of all burns. Burns therefore constitute an important area of public health care as well as an important sector of medical science.

Burns frequently necessitate specialized local treatment, which requires considerable consumption of material and human resources; for the patient, the therapeutic process is difficult, generating anxiety, pain, and stress.

All the cases reported here were subjected to the American Burn Association criteria.

There is a wide area of products for burns treatment. We have frequently used clorhexidine, tulle gras, and antibiotic ointments with very good results in superficial burns.

Over the last year, we have tested a new product (Immerci H3) for superficial and partial-thickness burns.

Immerci H3 is a hydroactive range that offers solutions in all phases of the healing process. The Immerci H3 range of products has the following properties:

• cicatrizing activity • pain reduction • debriding action (the absorption of fluids from the wound permits autolytic debridement) • bacteriostatic and bactericidal action, to be used in the event of non-infected wounds and also in superinfected wounds, which have malodorous discharges • action of preparing the cell pad for cicatrization and its stimulation: the anti-inflammatory effect and the absorption effect of the exudates, together with the moist environment, lead to stimulation of the granulation and cicatrization tissue • non-adherence to the tissue, so that removal is painless and without trauma • owing to its physical characteristics, the Immerci H3 range can be used in awkwardly positioned wounds

The Immerci H3 impregnated compress is a non-occlusive dressing with a complex structure:

• the meshed polyester lattice, which supports the compress, allows drainage of exudates to the absorbent compress covering the Immerci H3 impregnated compress, thus preventing maceration • the meshed polyester lattice allows migration of granulation tissue • since the ointment is applied on the yarn of the meshed polyester lattice, the Immerci H3 impregnated compress can be removed without pain or trauma.

The antibacterial action of the Immerci H3 range has the following properties (Table I):

Wound cicatrization is induced by the following constituents of the ointment (Table II):

Fifty patients of paediatric and adult age were recruited for clinical investigation in two burn units in Bucharest and Timisoara. A detailed description was made of the burn surfaces, including the following parameters: time elapsed since burn (hours), aetiology, initial surface (sq cm), localization, and other relevant features.

The patients were supervised by the clinical investigation team members until healing of the burn surface.

Determination of the burn surface was performed when the patients were recruited for clinical investigation and every time the Immerci H3 impregnated compress was removed from the burn area.

Multiple evaluations of the burn surface, including initial evaluation, were made.

Fig. 1 shows the number of days of treatment and the percentage of body surface area burned.

The horizontal axis shows the days of treatment and the vertical axis the percentages of the burn surfaces.

After the clinical investigation period, no infection of the burn surface appeared, thanks to the use of the Immerci H3 impregnated compress. It can be observed that on day 6 of treatment, the burn surface had decreased by more than half of the initial surface, i.e. it was 45.44% of the initial surface. On day 11 day of treatment, the burn surface had decreased by three-quarters (i.e. it covered 25.02% of the initial surface).

Compared to standard treatment for superficial burns, healing was achieved 2.9 days earlier. Treatment costs amounted to half those of standard treatment. Hospital stay decreased by 1.7 days.

Examples of clinical cases

Below we present some clinical cases.

The mean period of application on the burn of the Immerci H3 impregnated compress was 1.5 days.

Regarding acceptability, the Immerci H3 impregnated compress was in all cases removed from the burn area very easily, demonstrating the good level of product acceptability.

The medium level of pain intensity felt by the patients when removing the impregnated compresses Immerci H3 from the burn area was less than 1, meaning a pain which is almost insensible on the Wong-Baker scale.

Conclusions

The analysis of the clinical investigation demonstrates good efficacy of the impregnated compress Immerci H3 in burn treatment, as well as good tolerance and acceptability of the compress.

The Immerci H3 range is thus a useful local treatment indicated in local treatment for superficial burn surfaces.

RÉSUMÉ. Il y a un grand nombre de méthodes thérapeutiques locales pour le traitement des brûlures superficielles et partielles. Les brûlures exigent un traitement local méticuleux au cours de ce protocole thérapeutique complexe. Le traitement local des brûlures est essentiel, et il influence l’évolution du cas et l’avenir du patient. Toutes les méthodes pour le traitement local des brûlures doivent etre adaptées selon les aspects particulier des lésions causées par la brûlure (âge, étiologie, localisation, pathologies associées). La possibilité d’utiliser l’Immerci H3 dans le traitement des brûlures superficielles partielles a été testée du point de vue clinique et les résultats ont été favorables. La guérison a été plus rapide et la durée de l’hospitalisation réduite, comme aussi les coûts de l’hospitalisation.

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