Considering the fact that our method is a special combination of the dressing, an ethical approval was not requested by the Ethical Committee of our institutions for this prospective study. In patients treated with the combination of silver foam dressing with Zn-hyaluronic gel, the dressing was checked on the 2nd day and removed on the 6th or the 7th day. In cases, when the burn depth was II/B degree (or deeper), the patients were excluded from the study. When the burn was superficial (II/A), the above described conservative therapy (Aquacel Ag foam dressing with Zn-hyaluronic gel) was applied. At primary treatment, wound cleaning and blister removal was carried out under sedation or general anesthesia. On the following day, burn depth was reassessed by a burn specialist (consultant). In cases, when the burn depth was not clearly assessable (II/1 or II/2) by the primary surgeon, silver nitrate solution was used for 24 hours. Aquacel Ag foam dressing with Zn-hyaluronic gel was applied primarily after wound cleaning and blister removal, which included the removal of the vesicles and blisters (i.e., bullectomy which is not equivalent of necrectomy), but not the burned epidermis. In nearly 90% of the cases, burn depth was undoubtedly superficial. Thirty-seven children with superficial and mixed-type of second-degree hand burns were included in the study in whom the burning injury was treated with Zn-hyaluronic gel combined with Aquacel Ag foam. The aim of this study is to present the results obtained in children with superficial and mixed second-degree hand burn injuries treated simultaneously with Zinc-hyaluronic gel combined with a special silver foam dressing.īetween Januand January 31, 2017, a prospective clinical study was performed at the Surgical Division, Department of Paediatrics, Medical School, University of Pécs, Hungary. However, according to our knowledge, no data are available on the effect of the combination of these treatments in the same burn types. Ĭlinical studies with application of either Aquacel Ag foam or Curiosa gel have been conducted and beneficial effects of each treatment have been found in superficial second-degree burns. The main component of Curiosa gel (Richter, Hungary) is Zinc-hyaluronic acid, which promotes cell regeneration, therefore, it contributes to faster regeneration of the wound. However, only a limited number of studies exist in the pediatric population about its effectiveness. The dressing absorbs the wound secretion as the hydrofiber layer transforms into gel, which facilitates wound-humidification, faster healing, and protects against infections. These kinds of injuries require complex surgical interventions.Īquacel Ag (ConvaTec, USA) foam is a hydrofiber dressing which consists of a superficial polyurethane waterproof layer and a multi-layered absorbent surface containing 1.2% ionized silver. Bones can be involved in fourth-degree burn (carbonization), the affected area is homogeneously black and charred. Third-degree burn (widespread thickness with a white, leathery appearance) extends to all layers of the skin and occasionally even further. In mixed type of second-degree burn (II/A and II/B), in case of an appropriate indication, conservative treatment methods can also be used. In this case, the appropriate treatment is a surgical intervention to tangentially excise the necrotic skin part (debridement). In cases of partial burns, which extend to the deeper layer (II/B or II/2), also the reticular layer of the dermis is damaged. They can be divided into 2 further groups: Partial thickness lesion or second-degree burn (blisters covering a red base ) reaches the deeper skin layers, extending to the whole epidermis and the dermis. Generally, these superficial burns do not need medical care. The most moderate lesion – called as first-degree burn (redness of the skin, like sunburn) – affects only the superficial skin layers without blisters or a wound. Burns can be classified by the severity of damage to the skin layers (depth of burns) and the affected surface area of the skin (usually expressed as percentage of total body surface area ). Mechanism of the injury, duration of the exposure, depth and range of the burns, age, and general well-being of the child are all important influencing factors of the disease. The most common cause of hand burn injury in children is the scald from hot water. The most frequently affected age-group is the one <5 years of age. The degrees of burns refer to the depth of the affected tissue and range from first degree to third degree, with third degree burns being the deepest.Burn injury in childhood is mainly caused by extreme heat, electricity, chemicals, friction, or radiation. As part of the initial exam, the doctor will determine the severity and the percentage of burns.
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