Xeroform™ Stickdown Dressing: A New Technique for the Treatment of Pediatric Partial Thickness Burns
Jennifer Grauberger*, Nikita Joshi, Alex Joo, Alannah Phelan, Janice F. Lalikos
Division of Plastic Surgery, UMass Chan Medican School, Worcester, MA
Standard dressings for pediatric burns require frequent, painful and anxiety-inducing changes. Our institution adapted a skin graft donor site dressing into a "stickdown' burn dressing consisting of a one-time application of bacitracin and 3% bismuth tribromophenate/vaseline impregnated gauze (Xeroform™) that adheres to the burn and peels off as new epithelialized skin forms. This study aimed to compare clinical outcomes of the stickdown versus traditional dressings.
A retrospective cohort study of pediatric patients (age<18 yr) with partial thickness burns treated at a Level I pediatric trauma center over four years. Patients who received a standard dressing (N=74 "NSD") were matched to patients treated with a Xeroform™ stickdown protocol (N=37 "SD"). Propensity score matching based on age, burn depth (superficial vs deep partial thickness), mechanism of injury, and total body surface area (TBSA) was performed. Univariate analyses utilized Wilcoxon Rank Sum and Fisher's Exact tests.
The cohorts had similar demographics and burn characteristics. A similar number of patients were admitted to the hospital (31.1% NSD vs 32.4% SD, P=1.0). Hospital stays were longer in the standard dressing group but not significantly (median 2.0 days NSD vs 1.0 days SD, P=0.23). Stickdown patients utilized similar amounts of narcotics during their hospitalization (7.7+/-12.1 avg daily morphine milli-equivalents vs 5.1+/-9.5, P=0.91). There were no differences in outcomes such as time to burn re-epithelialization (median 13.0 NSD vs 12.0 SD days, P=0.20) or any wound healing complications. The only significant difference was median number of dressing changes (12.0 NSD vs 0.5 SD, P<0.0001).
The Xeroform™ stickdown dressing requires significantly fewer dressing changes and has equivalent clinical outcomes to standard dressings for the treatment of pediatric partial thickness burns. Decreasing dressing change frequency has the potential to decrease both anxiety during burn recovery and subsequent psychological effects, such as anxiety or PTSD, which commonly follow pediatric burns.
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