the burn glove trial - hand burn dressing pilot

Conditions: Burns

Summary: specific aim 1: to determine if one of three burn dressings provides a less painful healing experience for partial thickness hand. specific aim 2: to evaluate if one of three dressings provides greater functionality during and after healing of partial thickness hand burns. specific aim 3: to determine if one of three burn dressings promotes aesthetically superior healing results for partial thickness hand burns.

various products are on the market and available for use on partial thickness burns to the hand/s. our current institutional standard of care is to use xeroform gauze (coviden, mansfield, ma) and bacitracin ointment (fougera, melville, ny) to promote a moist antibacterial healing environment with the ability to monitor the healing progress daily. however, silver (ag) based dressings that employ nanocrystalline technology with hydrofiber (aquacel ag burn; convatec, princeton, nj) or soft silicone foam (mepilex ag ; molnlycke health care, dunstable, united kingdom) have been well accepted as alternative dressing solutions. these dressings have longer interval times between changes, leading to a reported increase in patient comfort, diminished skin shearing/stripping, and rapid re-epithelialization. given the anatomic intricacies, partial thickness burns to the hand present a challenge in dressing selection. recently, convatec unveiled the aquacel ag burn glove for use on partial thickness hand burns. in line with this idea, our institution has now begun to fashion a novel burn glove out of mepilex transfer ag with good success. to date there are no known studies that compare xeroform/bacitracin, aquacel ag burn glove or mepilex transfer ag dressing. the goal of this study is to compare these three burn dressings used to treat partial-thickness hand burns and their impact on pain, function, and aesthetic outcomes. we will also explore psychosocial issues related to hand burn dressing changes.

Eligibility criteria:
inclusion criteria: * patients presenting at memorial medical or southern illinois university (siu) health care * patients with partial-thickness burn injuries to the dorsum and/or palm of the hand/s that exceeds ½% total body surface area (tbsa) for at least one hand. * \< 10% tbsa 2nd and 3rd degree burn injuries * initial clinical presentation \< 5 days post burn injury exclusion criteria: * \< ½ % tbsa involving the hand * \> 10%tbsa burn injuries * \> 60 years of age * \< 8 years of age * patients (or parents of minors) without cognitive capacity to comprehend informed consent * presentation \> 5 days post-burn injury event * pregnant women * full thickness/3rd degree burns to the dorsal and/or palmer hand/s * exposed vital structures (tendons, nerves, bone, vessels) * uncontrolled type ii diabetes * type i diabetes * history of chronic obstructive pulmonary disease * have a known allergy to silver products * signs of infection on initial clinical presentation (presence of purulent drainage, significant cellulitis, and/or fever) * smoke/inhalation injuries requiring ventilation * critically ill patients requiring intensive care

Keywords: hand burns thermal dressing aquacel® mepilex® transfer ag xeroform® bacitracin® partial thickness epithelialization wound healing scar scarring