title: The use of a chitosan dressing with silver in the management of paediatric burn wounds: a pilot study.
abstract: OBJECTIVE
  Traditional burn dressings demonstrate unfavourable tendencies of shrinking when wet and failing to maintain their integrity when manipulated. To overcome these obstacles, gel-forming fibre dressings have emerged as an alternative. Our objective was to observe the clinical properties and healing ability in the setting of burn wounds in a paediatric centre of a chitosan-based dressing containing silver.
  
  
  METHODS
  A sample of 12 partial-thickness burns in 10 children were identified for treatment with the chitosan-based silver dressing. The dressings were moistened before application, and monitored for any shrinkage on application. Patients were monitored for healing at outpatient follow-up visits and the dressings were allowed to separate as healing occurred.
  
  
  RESULTS
  We treated 12 burns in 10 children with an average age of 5.2 years. The burns had an average proportion of total body surface area (TBSA) of 3.6 % and involved the trunk and all extremities. Wounds healed mostly or completely in an average of 8.3 days. Dressings retained their size when wet and integrity when removed. No burns were found to be infected at any point in the study.
  
  
  CONCLUSIONS
  The chitosan-based dressing offered an optimal environment for moist wound management, and did not demonstrate the shrinkage or disintegration that diminishes the clinical usability of widely used hydrofibre dressings. The burns healed within an expected period of time, and did not undergo any infectious processes. Based on the results of this pilot study, the chitosan-based silver dressing is deserving of further study as an alternative to traditional burn dressings.
authors.affiliation: MD candidate, Drexel University College of Medicine, Philadelphia PA.
authors.forename: S
authors.initials: S
authors.lastname: Massand
authors.affiliation: Drexel University College of Medicine, Philadelphia PA.
authors.forename: F
authors.initials: F
authors.lastname: Cheema
authors.affiliation: MD Candidate, Drexel University College of Medicine, Philadelphia PA.
authors.forename: S
authors.initials: S
authors.lastname: Brown
authors.affiliation: Attending Plastic Surgeon, St Christopher's Hospital for Children, Philadelphia PA, US.
authors.forename: W J
authors.initials: WJ
authors.lastname: Davis
authors.affiliation: Attending Plastic Surgeon, St Christopher's Hospital for Children, Philadelphia PA, US.
authors.forename: B
authors.initials: B
authors.lastname: Burkey
authors.affiliation: Chief, Section of Plastic surgery; Director of Pediatric Burn Center, St Christopher's Hospital for Children, Philadelphia PA, US.
authors.forename: P M
authors.initials: PM
authors.lastname: Glat
mesh_terms: D000293:Adolescent; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001458:Bandages; D002056:Burns / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D048271:Chitosan; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010865:Pilot Projects; D062326:Re-Epithelialization; D018030:Silver Compounds / Q000627:therapeutic use*; D014945:Wound Healing; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D018030:Silver Compounds; D048271:Chitosan
keywords: chitosan; gelling dressing; marine polysaccharide; paediatric burn; silver dressing