title: Optimal treatment of partial thickness burns in children: a systematic review.
abstract: A large part of the patient population of a burn centre consists of children, most of whom are younger than four years. The majority of these young children suffer from superficial and deep partial thickness scald burns that may easily deepen to full thickness burns. A proper wound therapy, that prevents infection and ensures a moist wound condition, might prevent the deterioration of the wound. Therefore, we performed a systematic review of wound management and dressing materials to select the best treatment option for children with burns. A search in Medline and Embase revealed 51 articles for a critical appraisal. The articles were divided into randomized controlled trials, cohort studies and a group of case-reports. Total appraisal did not differ much amongst the groups; the level of evidence was highest in the randomized controlled trials and lowest in the case-reports. In 16 out of 34 comparative studies, silver sulfadiazine or a silver sulfadiazine/chlorhexidine-gluconate combination was the standard of wound care treatment. The competitor dressing was Biobrane(®) in six studies and amnion membrane in three. Tulle gauze, or tulle gauze impregnated with an antibacterial addition were the standard of care treatment in seven studies. In general, membranous dressings like Biobrane(®) and amnion membrane performed better than the standard of care on epithelialization rate, length of hospital stay and pain for treatment of partial thickness burns in children. However, hardly any of the studies investigated long-term results like scar formation.
authors.affiliation: Burn Centre, Red Cross Hospital, Beverwijk, The Netherlands. Electronic address: jvloemans@rkz.nl.
authors.forename: A F P M
authors.initials: AF
authors.lastname: Vloemans
authors.affiliation: Hermans Consulting, Inc., Newtown, PA, USA.
authors.forename: M H E
authors.initials: MH
authors.lastname: Hermans
authors.affiliation: Burn Centre, Red Cross Hospital, Beverwijk, The Netherlands; Association of Dutch Burn Centres, Beverwijk, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, MOVE Research Institute, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: M B A
authors.initials: MB
authors.lastname: van der Wal
authors.affiliation: Burn Centre, Red Cross Hospital, Beverwijk, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Liebregts
authors.affiliation: Burn Centre, Red Cross Hospital, Beverwijk, The Netherlands; Association of Dutch Burn Centres, Beverwijk, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, MOVE Research Institute, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Middelkoop
mesh_terms: D000293:Adolescent; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001684:Biological Dressings; D002056:Burns / Q000473:pathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D012837:Silver Sulfadiazine / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; C042816:Biobrane; D020099:Coated Materials, Biocompatible; C010882:chlorhexidine gluconate; D002710:Chlorhexidine; D012837:Silver Sulfadiazine
keywords: Burns; Children; Paediatric burns; Partial thickness burns; Systematic review; Wound treatment