title: Biobrane versus topical agents in the treatment of adult scald burns.
abstract: BACKGROUND
  Limited data is available for treatment of scald lesions in adults. The use of the biosynthetic matrix Biobrane®has been suggested as treatment option with more benefits over topical dressings. Application of Biobrane®in scalds in our center led to a perceived increase of infection, secondary deepening, surgery and length of stay. We therefore assessed the effect of different treatment options in adult scalds in our center.
  
  
  METHODS
  We performed a retrospective cohort study of adult patients that have been admitted with scalds in our center between 2011 and 2014. We assessed two groups, group 1 with Biobrane®as initial treatment and group 2 with topical treatment using polyhexanid hydrogel and fatty gauze. Primary outcome variables were rate of secondary deepening, surgery, infection (defined as positive microbiological swabs and antibiotic treatment) and length of stay. Total body surface area (TBSA) as well as diabetes mellitus (DM), hypertension, smoking and alcohol consumption as potential confounders were included.
  
  
  RESULTS
  A total of 52 patients were included in this study. 36 patients received treatment with Biobrane®and 16 with ointment and fatty gauze. No significant differences were found for age and TBSA whereas gender ratio was different (25/11 male/female in group 1 vs 4/12 in group 2, p=0.003). Rate of secondary deepening, surgery, infection as well as days of hospital stay (DOHS) were comparable. Logistic and multilinear regression showed TBSA to be a predictive factor for infection (p=0.041), and TBSA and age for length of stay (age p=0.036; TBSA p=0.042) in group 1.
  
  
  CONCLUSIONS
  The use of Biobrane®in adult scald lesions is safe and non-inferior to topical treatment options. In elder patients and larger TBSA Biobrane®may increase the risk of infection or a prolonged stay in hospital.
  
  
  METHODS
  Level 3 - retrospective cohort study.
authors: Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: krezdorn.nicco@mh-hannover.de.
authors: Nicco
authors: N
authors: Krezdorn
authors: Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: Sören
authors: S
authors: Könneker
authors: Department of Plastic Surgery and Hand Surgery, AGAPLESION Diakonieklinikum Rotenburg, Elise-Averdieck-Straße 17, 27356 Rotenburg (Wümme), Germany.
authors: Felix Julian
authors: FJ
authors: Paprottka
authors: Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
authors: Christian
authors: C
authors: Tapking
authors: Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: Tobias R
authors: TR
authors: Mett
authors: Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: G Felix
authors: GF
authors: Brölsch
authors: Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: Maria
authors: M
authors: Boyce
authors: Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: Ramin
authors: R
authors: Ipaktchi
authors: Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
authors: Peter M
authors: PM
authors: Vogt
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D001645:Biguanides / Q000627:therapeutic use*; D001830:Body Surface Area; D002056:Burns / Q000453:epidemiology / Q000628:therapy*; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004202:Disinfectants / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D015599:Trauma Severity Indices; D014946:Wound Infection / Q000453:epidemiology*
chemical_list: D001645:Biguanides; C042816:Biobrane; D020099:Coated Materials, Biocompatible; D004202:Disinfectants; C031233:polihexanide
keywords: Adult scald; Biobrane; Burn wound infection; Scald lesion; Scald treatment