This study was approved by the University of Texas Medical Branch Institutional Review Board (15-0009). In this prospective randomized study, we sought to determine whether Suprathel ® is a feasible alternative to Mepilex Ag ® for the treatment of adult and pediatric partial-thickness burn wounds and to establish recommendations and indications for its use under preestablished outpatient conditions. The current standard of care for partial-thickness burns at our burn center consists of debridement under analgesia, coverage with silver-coated foam dressing (Mepilex Ag ®), and outpatient follow-up with dressing changes every 3 to 7 days until wound healing is complete. 10, 11 However, all clinical trial data comparing Suprathel ® with other dressings have been obtained in the inpatient setting, as partial-thickness burn wounds are typically treated on an inpatient basis in Europe and the United Kingdom. It has been successfully used in superficial, mixed, and deep partial-thickness burns in adult and pediatric patients. 6–9 A newer synthetic dressing for partial-thickness burns, Suprathel ® (PolyMedics Innovations GmbH, Denkendorf, Germany), consists of a thin polylactic acid membrane that is applied to the debrided burn wound and remains on the site until reepithelialization is complete, while allowing for wound inspection due to its translucent properties. Synthetic dressings, such as Biobrane ® (Smith & Nephew, Andover, MA) and Mepilex Ag ® (Mölnlycke, Göteborg, Sweden), can serve as an alternative to topical creams, ointments, antimicrobials, or biological dressings and combine the advantage of fewer required dressing changes with accelerated wound healing. While a wide variety of dressings are currently available, conclusive data on the most favorable treatment option for partial-thickness burns in an outpatient setting are sparse. 2 An ideal wound dressing serves as a barrier to prevent transdermal fluid loss, mitigates the risk of infection, allows reepithelialization of the wound surface, is cost-effective, is easy to use, and controls pain. 4 Standard treatment involves immediate debridement of nonviable tissue and coverage of the wound with dressings that provide favorable conditions for reepithelialization. 2, 3 Healing of the resulting wounds typically occurs within 2 to 3 weeks after injury, and significant scarring is not expected in superficial partial- thickness burns. 1 Depending on its duration and intensity, the thermal insult can affect both the epidermal and dermal layers of the skin it may extend superficially into the papillary dermis or deep into the reticular dermis and characteristically causes severe pain. Partial-thickness burns typically cover a relatively small percentage of TBSA and are a common occurrence in emergency and trauma as well as in specialized burn care. Reduced pain, especially in a pediatric patient population, may be advantageous, despite increased treatment cost. Both dressings are feasible and efficacious for the outpatient treatment of minor and selected moderate partial-thickness burns. The cost of treatment per square centimeter for Mepilex Ag was considerably lower than that of Suprathel. Patients treated with Suprathel reported better overall scar quality (S: 2 M: 4.5 P < 0.001). Viscolelasticity of burned skin was elevated compared with unburned skin in the Mepilex Ag group at 1 month post burn. Pain ratings were significantly reduced during the first 5 days after burn in the Suprathel group in all patients ( P = 0.03) and a pediatric subgroup ( P < 0.001). Time to reepithelialization was not different between the groups (12 days P = 0.75). Sixty-two patients (S n = 32 M n = 30) were enrolled age, sex, and burn size were comparable between the groups. Data are presented as mean ± SEM, and significance was accepted at P < 0.05. Objective scar characteristics (elasticity, transepidermal water loss, hydration, and pigmentation) and subjective assessments (Patient and Observer Scar Assessment Scale) were measured at 1 month post burn. We monitored time to reepithelialization, wound pain, discomfort during dressing changes, and treatment cost. Patients were enrolled in a randomized, controlled, prospective clinical trial. We compared Mepilex Ag (M), a silver-impregnated foam dressing, and Suprathel (S), a DL-lactid acid polymer, in the outpatient treatment of partial-thickness burns in pediatric and adult patients. Modern treatment of partial-thickness burns follows the paradigm of less frequent dressing changes to allow for undisturbed reepithelialization of the burn wound.
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