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Usefulness of Hydrocolloid Dressings in Pediatric Burns

Frassetto A, D’Acunto C, Orlandi C, Carboni A, Melandri D
Cesena, Italy

Abstract
  Hot liquids are the most common cause of burns in pre-school children, while the fire is the most common cause of burns in childhood. Scald injuries do not have a uniform depth and some days are needed to define the deep areas, this depends on the dynamics and characteristics of the liquid.

  A considerable advance in the dressing burns in children was made by advanced wound dressings based on hydrocolloids.

  In our Burns Centre we have been using for a long time with success hydrocolloid dressings that have some definite advantages. These create an occlusive moist environment that promotes the lysis of eschar and reepithelialization and are associated with reduction of dressing changes frequency.

  Furthermore, hydrocolloids do not adhere to the burned surface, so the dressing changes are minimally traumatic and they occur in the absence of pain. In particular, hydrocolloids have been effective in the intermediate dermal burns where the damage does not involve the full thickness skin so medications can promote reepithelialization from skin appendages.

  Of course, surgical therapy is the treatment of choice in full-thickness burns. In this retrospective study we tried to assess the effectiveness of hydrocolloids in the last fifteen years and how they allowed a conservative treatment of intermediate burns, helping to reduce the incidence of surgery.

References

1. Lee JO, Herndon DN. The pediatric burned patient. 3ed Total Burn Care Sauders Elsevier 2007.

2. Wyatt D, McGowan DN, Najarian MP. Comparison of a hydrocolloid dressing and silver sulfadiazine cream in the outpatient management of second-degree burns. J Trauma. 1990 Jul;30(7):857-65.

3. Bowler PG, Delargy H, Prince D, Fondberg L. The viral barrier properties of some occlusive dressings and their role in infection control. WOUNDS. 1993;5:1-8.

4. Thomas SS, Lawrence JC, Thomas A. Evaluation of hydrocolloids and topical medication in minor burns. J Wound Care. 1995 May;4(5):218-20.

5. Muangman P, Muangman S, Opasanon S, Keorochana K, Chuntrasakul C. Benefit of hydrocolloid SSD dressing in the outpatient management of partial thickness burns.J Med Assoc Thai. 2009 Oct;92(10):1300-5.

6. Martin FT, O’Sullivan JB, Regan PJ, McCann J, Kelly JL. Hydrocolloid dressing in pediatric burns may decrease operative intervention rates. J Pediatr Surg. 2010 Mar;45(3):600-5.

Soft Tissue Lesions in Paediatric Neuroorthopaedic Practice

Kenis V, Baindurashvili A
St. Petersburg, Russia

Abstract
  Neuroorthopaedics is intensively growing branch of paediatric orthopaedic surgery which covers many borderline specialties. Progress of rehabilitation medicine makes more important surgical treatment even in those cases, which seemed to be incurable previously. Severe handicapped children with cerebral palsy, spina bifida, arthrogriposis multiplex. Pour condition of skin and soft tissues, movement deficit make extremely important special approach to prevention and treatment of the lesions.

  Most often cause of the soft tissue damage in neuroorthopaedic patients is pressure sore in plaster casts and orthoses. Prevention of this kind of lesions consists mostly of correct casting and orthotic management. Proper surgical technique, taking into account risk factors and neurological condition gives possibility to minimize number of complications.

  In children with appearance of soft tissue lesions differentiated approach should be allied, depending on the stage of the process, age of patient, character of neurological deficit.