[The Biobrane glove in burn wounds of the hand. Evaluation of the functional and aesthetic outcome and comparison of costs with those of conventional wound management].
BACKGROUND
While use of biocomposite temporary dressings in burn wounds is common practice, the complex anatomic structures of the hand make this treatment option challenging. For this reason, the Biobrane ((R)) Glove (Smith&Nephew) has been developed. However, limited information regarding burn treatment with Biobrane ((R)) Gloves can be found in the literature.


METHODS
Functional and cosmetic outcomes of 13 second degree burn wounds of the hand in 10 patients treated with Biobrane ((R)) Gloves were evaluated using the Vancouver scar scale (VSS) and the DASH-score (disabilities of the arm, shoulder and hand). We evaluated wound healing times and questioned patients about pain related to Biobrane ((R)) Glove treatment in comparison to conventionally managed second degree burn wounds in other parts of the body and about acceptance of Biobrane ((R)) Glove treatment. In addition, we estimated the costs for use and wound management time for both Biobrane ((R)) Glove treatment and conventional wound management for 14 days.


RESULTS
Burn wounds treated with Biobrane ((R)) Gloves had excellent functional and cosmetic outcomes [DASH score median of 0 (min. 0; max. 3.33) and VSS median of 3 (min. 0; max. 5)]. Wound healing times were lower (mean 9 days). According to patients' response to overall acceptance, 90% responded as being "very satisfied" with Biobrane ((R)) Glove treatment and 75% responded that Biobrane ((R)) Glove treatment was "much less painful" compared to conventional burn management. The material costs of the Biobrane ((R)) Glove treatment, over 14 days, were approx. double compared to conventional wound management costs. In contrast, the time required for conventional wound management over 14 days was four times longer than for treatment with Biobrane ((R)) Gloves. Thus, taking personnel expenses into consideration, total costs of Biobrane ((R)) Glove treatment are comparable to those of conventional wound management.


CONCLUSIONS
Biobrane ((R)) Glove treatment of hand burns resulted in excellent functional and cosmetic outcomes, reduced pain compared to conventional wound management and high overall patient satisfaction. In conjunction with a significant reduction in wound management time, the Biobrane ((R)) Glove is an important and cost neutral tool in the treatment of second degree burn wounds of the hand.
Busche
M N
MN
Medizinische Hochschule Hannover, Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Zentrum für Schwerbrandverletzte, Hannover, Germany. marcbusche@web.de
Herold
C
C
Schedler
A
A
Knobloch
K
K
Vogt
P M
PM
Rennekampff
H-O
HO
D000293:Adolescent; D000328:Adult; D000368:Aged; D002056:Burns / Q000191:economics* / Q000628:therapy*; D002921:Cicatrix / Q000191:economics / Q000517:prevention & control; D020099:Coated Materials, Biocompatible / Q000191:economics*; D003362:Cost-Benefit Analysis; D004954:Esthetics; D005260:Female; D005858:Germany; D006230:Hand Injuries / Q000191:economics* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings / Q000191:economics*; D017060:Patient Satisfaction; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
C042816:Biobrane; D020099:Coated Materials, Biocompatible