title: A retrospective cohort study of Acticoat versus Silvazine in a paediatric population.
abstract: We wished to determine whether changing our centre's practice of using Acticoat instead of Silvazine as our first-line burns dressing provided a better standard of care in terms of efficacy, cost and ease of use. A retrospective cohort study was performed examining 328 Silvazine treated patients from January 2000 to June 2001 and 241 Acticoat treated patients from July 2002 to July 2003. During those periods the respective dressings were used exclusively. There was no significant difference in age, %BSA and mechanism of burn between the groups. In the Silvazine group, 25.6% of children required grafting compared to 15.4% in the Acticoat group (p=0.001). When patients requiring grafting were excluded, the time taken for re-epithelialisation in the Acticoat group (14.9 days) was significantly less than that for the Silvazine group (18.3 days), p=0.047. There were more wounds requiring long term scar management in the Silvazine group (32.6%) compared to the Acticoat group (29.5%), however this was not significant. There was only one positive blood culture in each group, indicating that both Silvazine and Acticoat are potent antimicrobial agents. The use of Acticoat as our primary burns dressing has dramatically changed our clinical practice. Inpatients are now only 18% of the total admissions, with the vast majority of patients treated on an outpatient basis. In terms of cost, Acticoat was demonstrated to be less expensive over the treatment period than Silvazine . We have concluded that Acticoat is a safe, cost-effective, efficacious dressing that reduces the time for re-epithelialisation and the requirement for grafting and long term scar management, compared to Silvazine.
authors.affiliation: Royal Children's Hospital Burns Research Group, University of Queensland, Department of Paediatrics and Child Health, Royal Children's Hospital, Herston, Queensland 4029, Australia.
authors.forename: Leila
authors.initials: L
authors.lastname: Cuttle
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Naidu
authors.forename: Julie
authors.initials: J
authors.lastname: Mill
authors.forename: Wendy
authors.initials: W
authors.lastname: Hoskins
authors.forename: Karina
authors.initials: K
authors.lastname: Das
authors.forename: Roy M
authors.initials: RM
authors.lastname: Kimble
mesh_terms: D000891:Anti-Infective Agents, Local / Q000191:economics / Q000627:therapeutic use*; D002056:Burns / Q000191:economics / Q000628:therapy*; D017028:Caregivers / Q000523:psychology; D002675:Child, Preschool; D015331:Cohort Studies; D003258:Consumer Behavior; D003365:Costs and Cost Analysis; D006801:Humans; D007902:Length of Stay; D009824:Ointments; D011091:Polyesters / Q000191:economics / Q000627:therapeutic use*; D011095:Polyethylenes / Q000191:economics / Q000627:therapeutic use*; D012189:Retrospective Studies; D012837:Silver Sulfadiazine / Q000191:economics / Q000627:therapeutic use*; D016038:Skin Transplantation / Q000191:economics / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: C117408:Acticoat; D000891:Anti-Infective Agents, Local; D009824:Ointments; D011091:Polyesters; D011095:Polyethylenes; D012837:Silver Sulfadiazine