Comparing a High-concentration Topical Surfactant With and Without a Topical Antimicrobial in the Management of BurnsTimothy Pittenger, MD; Danielle Curran, RN; and Michel H. Hermans, MD
OBJECTIVE: A surface-acting agent based on concentrated surfactant technology (CST), in certain patients in combination with a topical antimicrobial agent, was studied for both debriding properties and wound healing-related aspects in a trial in patients with burns.
MATERIALS AND METHODS: Patients with burns of different depths, not exceeding 10% total body surface area (TBSA), were enrolled. They were treated with CST gel, with (N = 26) or without (N = 24) the addition of a topical antimicrobial cream. The clinical need for the method of debridement was assessed, as was time towards healing progress and reepithelialization within a limited time frame.
RESULTS: Fifty patients (median age, 35.0; median study burn, 2.0% TBSA [range, 0.1–9.0]) participated. Most burns were located on the lower leg/foot or arm/hand. Four wounds (8%) were superficial partial thickness. All others (92%) were complete or a mixture of deep-partial and full-thickness wounds. One wound was excised with a dermatome, 4 used a debriding enzyme, and the remaining were treated primarily with CST (1 lesion with adjunct negative pressure wound therapy). The mean time to complete reepithelialization (N = 27; 54%) was 17.0 days. Fourteen burns (28%) showed progression to complete reepithelialization and treatment regimen was changed after the allotted trial time. Five burns (10%) did not show enough healing progress and were partially grafted. In 4 patients, complications led to a change of treatment. Infection (cellulitis) occurred in 1 patient treated with CST alone.
CONCLUSIONS: Excision and grafting is the standard therapy for most deep-partial and full-thickness burns. In this series of burn patients, 92% of all lesions were deep but only 5 (10%) required grafting. These results indicate that CST is a promising way to treat deep burns. It assists in debriding and in the healing process and helps avoid the need for grafting. Also, the antibiotic cream may have helped prevent infection.
Pittenger T, Curran D, Hermans MH. Comparing a high-concentration topical surfactant, with and without a topical antimicrobial, in the management of burns. Poster presented at: Symposium on Advanced Wound Care Fall; November 2-4, 2018; Las Vegas, NV.
Product: Plurogel (Medline Industries, Northfield, IL)
This abstract was not subject to the WOUNDS peer-review process.