Optimizing the use of Aquacel Ag® for pediatric burns - When to start?

Most pediatric burns are 2nd degree partial thickness, and most will heal spontaneously by providing a good healing environment, though there is no standardized treatment protocol. Aquacel Ag® has shown good clinical results in reducing the need for frequent dressing changes in the pediatric population. This study's goal was to review our experience using this dressing for pediatric partial thickness burns in order to optimize and customize its use. A retrospective study included all pediatric patients suffering from burns, admitted to our institution between July 2013 and May 2018. We investigated a total of 705 dressing changes in our cohort of 276 patients. The most prevalent dressing material was Aquacel Ag®, used in 48% of cases. We examined the pattern of using Aquacel Ag® dressings. The average time until dressing change was required proved to be much longer when applied on the 1st day after burn and onward in comparison to the day of injury (4.85 vs. 2.21 days, p<0.001). Moreover, when it was applied on the 1st day after burn, a dressing used on a superficial 2nd degree burn needed to be changed less often than when it was applied on a deep 2nd degree burn (4.95 vs. 2.29 days, p=0.024). To optimize its use and cost effectiveness, dressing with Aquacel Ag® should be initiated on the 1st day after burn, or on the 2nd day when a deep 2nd degree burn is suspected; until then a standard topical preparation should be used.