A double-blind, randomized, controlled trial evaluating a surfactant-based wound dressing for tissue salvage and reduction in surgical burden of partial-thickness burns (EARLY).

Abstract

Water-soluble surfactant dressings (WSD) have been utilized in chronic, non-healing wounds and small burn wounds to soften and aid removal of wound debris. We conducted a double-blind, randomized controlled study evaluating paired, non-contiguous partial thickness burn wounds comparing WSD vs bacitracin. We hypothesized early application of WSD would lead to less wound conversion and less painful wound care. Patients were consented and treatment applied within 24 h of injury. All cases were deemed necessary for admission at least initially. Patients were followed until 95 % re-epithelialization occurred or discharge. Vancouver scar scale was utilized post discharge. Twenty-seven patients were consented with 26 contributing data. The average time from injury to consent was 14.6 ± 5.6 h. The average age was 40.9 ± 16.5 years with 65 % being male, 50 % Black, and 50 % Caucasian. Flame injury was the most common. The average total body surface area burned was 8.8 ± 3.6 %. Regarding primary outcome, there was no difference in percent of salvaged tissue, calculated as the amount excised (cm²) relative to the original size of injury [6.1 % (95 % CI - 9.7, 21.9), p = 0.4363); 26.9 % vs 38.5 % of patients had their wounds convert to a deeper injury. However, there was a significant difference [-0.61 (95 % CI - 1.04, - 0.17), p = 0.0065) in patient reported pain between treatment assignment (measured at baseline and after each wound care session). WSD is a useful dressing that can be easily applied early after injury and can improve patient's wound care experience.