title: Treatment of Children With Scalds by Xenografts: Report From a Swedish Burn Centre.
abstract: Scalds are the most common type of burn in children, and one way to treat them is with xenografts with no topical antimicrobials in line with the recommendations of a recent review. However, this treatment has not been examined in detail. Our aim was to describe the treatment of such children when biological dressings (xenografts) were used without local antimicrobials. We reviewed the medical records of all children admitted to a Swedish National Burn Centre during the period 2010-2012 with scalds who were treated with xenografts. Percentage TBSA injured, age, length of hospital stay, number of operations, antibiotics given, duration of antibiotic treatment, and pain score during the first 3 days, application of xenografts, and clinical notes of wound infection were recorded. We studied 67 children, (43 of whom were boys), with a median (interquartile range [IQR]) age of 1 (1-2) year and median (IQR) TBSA% 6.2 (4-11). Twenty children (30%) required operation. Twelve (18%) developed a wound infection, 29 (43%) had other infections, and 26 (39%) were free from infection. The median (IQR) duration of systemic antibiotics was 10 (6-13) days. On the day that the xenografts were applied 10 of the children had a Face, Legs, Activity, Cry, and Consolability (FLACC) score between 3 and 7, and during the following 2 days, only four children scored in this range. The remaining 57 children had scores < 3 on the day that xenografts were applied and on the following 2 days. Median (IQR) length of stay/TBSA% was 0.7 (0.4-1.0). Treatment with xenografts was associated with median length of stay/TBSA% <1 and low pain scores. Despite a high rate of prescription of systemic antibiotics, most were for reasons other than wound infection.
authors.affiliation: From the *The Burn Centre, Department of Hand Surgery, Plastic Surgery, and Burns, †The Burn Centre, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; ‡Plastic Surgery Unit, Surgery Department, Suez Canal University, Ismailia, Egypt; and §The Burn Centre, Department of Anaesthesiology and Intensive Care, Linköping University, Linköping, Sweden.
authors.forename: Moustafa
authors.initials: M
authors.lastname: Elmasry
authors.forename: Ingrid
authors.initials: I
authors.lastname: Steinvall
authors.forename: Johan
authors.initials: J
authors.lastname: Thorfinn
authors.forename: Ashraf H
authors.initials: AH
authors.lastname: Abbas
authors.forename: Islam
authors.initials: I
authors.lastname: Abdelrahman
authors.forename: Osama A
authors.initials: OA
authors.lastname: Adly
authors.forename: Folke
authors.initials: F
authors.lastname: Sjöberg
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001684:Biological Dressings; D002053:Burn Units; D002056:Burns / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D064593:Heterografts / Q000637:transplantation*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D013548:Sweden; D014946:Wound Infection
chemical_list: D000900:Anti-Bacterial Agents