Burns Clinical Trial
Official title:
Prospective Randomized Trial of Polymem vs. Bacitracin/Xeroform for Superficial Second Degree Burns
Patients will be screened at the initial visit to the burn center. If the patients are
eligible according to the inclusion/exclusion criteria, consent for the study will be
obtained. One of the investigators will identify two sites that appear to be the same depth
on each patient [1 site Polymen and 1 site bacitracin/xeroform )]. The depth of injury will
be verified as partial thickness using laser doppler. Each site will be at least 4cm x 4cm in
size. One site will be identified for bacitracin/xeroform and one site for Polymen. All burns
will be initially debrided and cleaned according to burn unit protocol. The dressing will
then be applied. All dressings will be covered with cotton gauze and ace wraps. Laser Doppler
will be utilized to determine burn depth at both the trial and control sites. On each
subsequent visit, patients will rate the pain of the dressing change on a 1-10 pain intensity
scale. It will be noted if the wound appears infected or if antibiotics are prescribed.
The study will end for each patient when the investigator determines that 95% of their burn
has re-epithelized.
Superficial second degree burns are limited to the epidermis and superficial layer of the
dermis and are expected to heal without the need of surgery if they are treated
appropriately. Complications such as desiccation of the wound or infection may extend the
depth of the injury and result in an increase in scarring or the requirement for excision of
the burn and skin grafting. The MetroHealth Burn Center treats over 1500 patients a year for
superficial second degree burns.
Various methods are used from the conventional dressing methods using guaze to the methods
that use biological materials such as skin from cadavers, pig's skin and artificial synthetic
materials. Our present burn care involves initial superficial outpatient debridement of the
burn wound and application of a dressing. This dressing consists of bacitracin applied to the
burn wound and xeroform covered by cotton gauze and ace-wrap. The majority of our patients
are unable to change this dressing by themselves and they either return to the burn center
daily for wound care or we arrange for a visiting nurse.
Polymem is a novel dressing which has been approved by the FDA for open wounds including
burns.Polymem is a hydrophilic polyurethane membrane pad with a semi permeable polyurethane
film backing. The pad contains a wound cleanser (F68 surfactant), a moisturizer (glycerin)
and an absorb ing agent (super-absorbent polymem). The F86 surfactant is involved in
dissolving the superficial necrotic layer of the burn and helps clean the burn site. Glycerin
acts as a moisturizer and prevents the pad from sticking to the wound. The absorbing agent
maintains the moisture of the wound which has been shown to increase wound healing. It also
allows the dressing to remain on the wound for three days. Kim et al conducted a study of 44
patients with second degree burns and demonstrated an increase in healing time, more comfort,
and a decrease in dressing changes with the use of Polymem.
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