Comparison of Mepitel Ag vs Antibiotic Ointment Used With Soft Cast Technique for Treatment of Pediatric Burns

NCT ID: NCT02681757

Last Updated: 2019-12-18

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

96 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-30

Study Completion Date

2017-09-29

Brief Summary

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The aim of this study is to compare Mepitel Ag to Triple antibiotic ointment impregnated Adaptic gauze when used with the soft cast technique to assess overall time to healing, yeast infection rate and parents perception of pain level at time of dressing change on a scale of 1-10. The hypothesis is that Mepitel Ag in combination with the soft cast technique improves wound healing in pediatric partial to deep partial thickness hand and foot burns by decreasing the length of healing time, decreasing the risk of yeast infection, and decreasing pain associated with dressing changes.

Detailed Description

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There is currently no gold standard dressing when it comes to treating hand or foot burns, specifically in the pediatric population. Our institution currently utilizes the soft cast technique (SCT) on all of our hand and foot burns. The SCT uses triple antibiotic ointment (TAO) impregnated Adaptic gauze, kling or kerlex, cast padding, gypsoma plaster, soft cast material, and coban. This dressing is applied one to two times during the first 2 weeks post injury. The underlying dressing is changed to nystatin impregnated Adaptic gauze, kling or kerlex, cast padding, gypsoma plaster, soft cast material, and coban for the remainder of treatment time or until surgery is indicated for debridement and grafting of wounds. The soft cast technique provides optimal positioning of the wounded hand or foot, allows for a moist wound environment, and offers protection of the injured extremity as the wound heals. The literature reveals that early surgical intervention performed in the first 7 to 10 days post injury has been shown to help achieve maximal function while decreasing the risk of hypertrophic scar formation.

A review of the current literature demonstrates silver sulfadiazine (SSD) to be the most frequently used dressing for burn wound treatment in many clinics nationwide. The use of SSD is associated with once to twice daily painful dressing changes and wound exposure that "may lead to disruption of newly formed epithelium, wound colonization, subsequent wound infection and deepening of the burn". One major benefit of the SCT is the reduction in required dressing changes, as the soft cast can stay in place for 7-10 days while maintaining optimal hand or foot positioning. This eliminates the need for painful dressing changes. Occasionally in our clinic, we have observed yeast infections under the soft cast when patients require serial casting. Other complications include occasional drying out of the adaptic gauze, which leads to painful dressing removal and interruption of the newly epithelialized wound bed. Mepitel Ag, a new soft silicone dressing produced by Molnlycke Health Care, combines Safetac technology with a silver compound to provide a broad spectrum of antimicrobial coverage, lasting up to 8 days, while minimizing damage to the new epithelium and creating a moist wound environment. The safetac technology "protects the wound and the skin. It prevents an outer dressing from sticking to the wound, therefore minimizes trauma and pain". The highly pliable nature and antimicrobial properties of the dressing make it an ideal alternative to TAO and SSD for the treatment of pediatric partial to deep partial thickness hand and foot burns.

Conditions

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Burns

Keywords

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pediatric hand burn pediatric foot burn mepitel Ag soft cast technique for burn wound heaing

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Control- triple antibiotic ointment

triple antibiotic ointment (TAO) impregnated Adaptic gauze, kling or kerlex, cast padding, gypsoma plaster, soft cast material, and coban

Group Type ACTIVE_COMPARATOR

triple antibiotic ointment dressing

Intervention Type DEVICE

used for control group under soft cast

Variable- mepitel Ag

mepitel Ag, kling or kerlex, cast padding, gypsoma plaster, soft cast material, and coban

Group Type EXPERIMENTAL

Mepitel Ag

Intervention Type DEVICE

used for variable/experimental group under soft cast

Interventions

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triple antibiotic ointment dressing

used for control group under soft cast

Intervention Type DEVICE

Mepitel Ag

used for variable/experimental group under soft cast

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Children's Hospital Colorado burn patients
* Age 31 days to 18 years
* Newly diagnosed partial to deep partial or full thickness hand or foot burns, including bilateral or unilateral injury

Exclusion Criteria

* silver allergy
* silicone allergy
* electrical burn
* chemical burn
* past medical history of immunodeficiency disorders such as diabetes mellitus
* h/o AIDs or HIV,
* h/o pregnant women
* prisoners
* decisionally challenged
Minimum Eligible Age

31 Days

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Colorado, Denver

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Steven Moulton, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of Colorad, Childrens Hospital Colorado

Locations

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Children's Hospital Colorado

Aurora, Colorado, United States

Site Status

Countries

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United States

References

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Abu-Sittah GS, El Khatib AM, Dibo SA. Thermal injury to the hand: review of the literature. Ann Burns Fire Disasters. 2011 Dec 31;24(4):175-85.

Reference Type BACKGROUND
PMID: 22639560 (View on PubMed)

Barret JP, Herndon DN. Plantar burns in children: epidemiology and sequelae. Ann Plast Surg. 2004 Nov;53(5):462-4. doi: 10.1097/01.sap.0000136973.62109.cf.

Reference Type BACKGROUND
PMID: 15502462 (View on PubMed)

Briggs SL, Taylor A, Lansdown AB. Clinical perspective on silicone dressings and wound management. J Wound Care. 2008 Aug;17(8):364-5; author reply 365-6. doi: 10.12968/jowc.2008.17.8.30801. No abstract available.

Reference Type BACKGROUND
PMID: 18754199 (View on PubMed)

Brown M, Dalziel SR, Herd E, Johnson K, Wong She R, Shepherd M. A Randomized Controlled Study of Silver-Based Burns Dressing in a Pediatric Emergency Department. J Burn Care Res. 2016 Jul-Aug;37(4):e340-7. doi: 10.1097/BCR.0000000000000273.

Reference Type BACKGROUND
PMID: 26171678 (View on PubMed)

Bugmann P, Taylor S, Gyger D, Lironi A, Genin B, Vunda A, La Scala G, Birraux J, Le Coultre C. A silicone-coated nylon dressing reduces healing time in burned paediatric patients in comparison with standard sulfadiazine treatment: a prospective randomized trial. Burns. 1998 Nov;24(7):609-12. doi: 10.1016/s0305-4179(98)00095-3.

Reference Type BACKGROUND
PMID: 9882058 (View on PubMed)

Choi M, Armstrong MB, Panthaki ZJ. Pediatric hand burns: thermal, electrical, chemical. J Craniofac Surg. 2009 Jul;20(4):1045-8. doi: 10.1097/scs.0b013e3181abb25f.

Reference Type BACKGROUND
PMID: 19634213 (View on PubMed)

Duteille F, Jeffery SL. A phase II prospective, non-comparative assessment of a new silver sodium carboxymethylcellulose (AQUACEL((R)) Ag BURN) glove in the management of partial thickness hand burns. Burns. 2012 Nov;38(7):1041-50. doi: 10.1016/j.burns.2012.05.001. Epub 2012 Jun 5.

Reference Type BACKGROUND
PMID: 22677163 (View on PubMed)

Feldmann ME, Evans J, O SJ. Early management of the burned pediatric hand. J Craniofac Surg. 2008 Jul;19(4):942-50. doi: 10.1097/SCS.0b013e318175f38d.

Reference Type BACKGROUND
PMID: 18650716 (View on PubMed)

Gee Kee E, Kimble RM, Cuttle L, Stockton K. Comparison of three different dressings for partial thickness burns in children: study protocol for a randomised controlled trial. Trials. 2013 Nov 25;14:403. doi: 10.1186/1745-6215-14-403.

Reference Type BACKGROUND
PMID: 24274190 (View on PubMed)

Johnson J, Silverberg R. Serial casting of the lower extremity to correct contractures during the acute phase of burn care. Phys Ther. 1995 Apr;75(4):262-6. doi: 10.1093/ptj/75.4.262.

Reference Type BACKGROUND
PMID: 7899484 (View on PubMed)

Meuleneire F, Rucknagel H. Soft Silicone dressings made easy. Wounds International 2013.

Reference Type BACKGROUND

Mitura K, Oslowska J, Mitura A. A Change of Traditional Method of Treatment of Partial Thickness Burn with Hydrofibre Dressings. Pol Przegl Chir. 2015 Feb;87(2):91-6. doi: 10.1515/pjs-2015-0025.

Reference Type BACKGROUND
PMID: 26146101 (View on PubMed)

White R, Morris C. Mepitel: a non-adherent wound dressing with Safetac technology. Br J Nurs. 2009 Jan 8-21;18(1):58-64. doi: 10.12968/bjon.2009.18.1.93582.

Reference Type BACKGROUND
PMID: 19127235 (View on PubMed)

Toussaint J, Chung WT, Osman N, McClain SA, Raut V, Singer AJ. Topical antibiotic ointment versus silver-containing foam dressing for second-degree burns in swine. Acad Emerg Med. 2015 Aug;22(8):927-33. doi: 10.1111/acem.12723. Epub 2015 Jul 22.

Reference Type BACKGROUND
PMID: 26202791 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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15-1828

Identifier Type: -

Identifier Source: org_study_id