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Topical antibiotic ointment versus silver-containing foam dressing for second-degree burns in swine.
Acad Emerg Med. 2015 Aug; 22(8):927-33.AE

Abstract

OBJECTIVES

Second-degree burns are very common but their management is controversial. These burns may be treated with either topical antimicrobial agents or advanced occlusive dressings; however, there is no established treatment comparator for preclinical studies. This study was designed to determine which of two commonly used comparator therapies (a silver-containing advanced dressing or a topical antibiotic ointment) resulted in faster reepithelialization and less scarring. The hypothesis was that second-degree burns treated with a topical antimicrobial ointment would heal faster and with less scarring than those treated with a silver-containing occlusive foam dressing in a porcine model.

METHODS

Deep partial-thickness burns were created on the flanks of three anesthetized female domestic pigs (20 to 25 kg) using a 150-g aluminum bar preheated in 80°C water bath and applied to the skin for 20 seconds using a force of 2 kg. The burn eschars were excised 48 hours later with an electric dermatome set at a depth of 0.75 mm. The wound beds were treated with a thin layer of triple-antibiotic petrolatum-based ointment (changed three times weekly) or a silver-containing foam dressing (changed once weekly). Full-thickness punch biopsies were obtained at 9, 11, 14, 16, 18, and 21 days for determination of percentage complete wound reepithelialization and at 28 days for measurement of scar depth.

RESULTS

At all dressing changes the wounds treated with the topical antibiotic appeared moist, while those treated with the silver-based dressings appeared dry. At day 21 all wounds treated with the ointment were completely reepithelialized, while only 55% of those treated with the silver dressing were reepithelialized (p < 0.001). Scar depth at day 28 was also significantly less in wounds treated with the topical antibiotic ointment (4.3 mm vs. 5.1 mm, difference = 0.7 mm; 95% confidence interval [CI] = 0.1 to 1.4 mm). There was less scar contraction in wounds treated with the topical antibiotic compared with the silver-based dressing (mean ± SD = 25.0% ± 14.6% vs. 38.9% ± 16.9%, difference = 13.9%; 95% CI = 5.7% to 22.0%).

CONCLUSIONS

In this model of excised deep partial-thickness burns, a triple-antibiotic ointment enhanced reepithelialization and reduced scar depth and contraction compared with a silver-based foam dressing. This triple-antibiotic ointment should be considered as a control for studies evaluating novel topical burn therapies.

Authors+Show Affiliations

Department of Emergency Medicine, Stony Brook University, Stony Brook, NY.Department of Emergency Medicine, Stony Brook University, Stony Brook, NY.Department of Emergency Medicine, Stony Brook University, Stony Brook, NY.Department of Emergency Medicine, Stony Brook University, Stony Brook, NY.Department of Emergency Medicine, Stony Brook University, Stony Brook, NY.Department of Emergency Medicine, Stony Brook University, Stony Brook, NY.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26202791

Citation

Toussaint, Jimmy, et al. "Topical Antibiotic Ointment Versus Silver-containing Foam Dressing for Second-degree Burns in Swine." Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, vol. 22, no. 8, 2015, pp. 927-33.
Toussaint J, Chung WT, Osman N, et al. Topical antibiotic ointment versus silver-containing foam dressing for second-degree burns in swine. Acad Emerg Med. 2015;22(8):927-33.
Toussaint, J., Chung, W. T., Osman, N., McClain, S. A., Raut, V., & Singer, A. J. (2015). Topical antibiotic ointment versus silver-containing foam dressing for second-degree burns in swine. Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine, 22(8), 927-33. https://doi.org/10.1111/acem.12723
Toussaint J, et al. Topical Antibiotic Ointment Versus Silver-containing Foam Dressing for Second-degree Burns in Swine. Acad Emerg Med. 2015;22(8):927-33. PubMed PMID: 26202791.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Topical antibiotic ointment versus silver-containing foam dressing for second-degree burns in swine. AU - Toussaint,Jimmy, AU - Chung,Won Taek, AU - Osman,Naureen, AU - McClain,Steve A, AU - Raut,Vivek, AU - Singer,Adam J, Y1 - 2015/07/22/ PY - 2015/01/23/received PY - 2015/03/04/revised PY - 2015/03/04/accepted PY - 2015/7/24/entrez PY - 2015/7/24/pubmed PY - 2016/2/26/medline SP - 927 EP - 33 JF - Academic emergency medicine : official journal of the Society for Academic Emergency Medicine JO - Acad Emerg Med VL - 22 IS - 8 N2 - OBJECTIVES: Second-degree burns are very common but their management is controversial. These burns may be treated with either topical antimicrobial agents or advanced occlusive dressings; however, there is no established treatment comparator for preclinical studies. This study was designed to determine which of two commonly used comparator therapies (a silver-containing advanced dressing or a topical antibiotic ointment) resulted in faster reepithelialization and less scarring. The hypothesis was that second-degree burns treated with a topical antimicrobial ointment would heal faster and with less scarring than those treated with a silver-containing occlusive foam dressing in a porcine model. METHODS: Deep partial-thickness burns were created on the flanks of three anesthetized female domestic pigs (20 to 25 kg) using a 150-g aluminum bar preheated in 80°C water bath and applied to the skin for 20 seconds using a force of 2 kg. The burn eschars were excised 48 hours later with an electric dermatome set at a depth of 0.75 mm. The wound beds were treated with a thin layer of triple-antibiotic petrolatum-based ointment (changed three times weekly) or a silver-containing foam dressing (changed once weekly). Full-thickness punch biopsies were obtained at 9, 11, 14, 16, 18, and 21 days for determination of percentage complete wound reepithelialization and at 28 days for measurement of scar depth. RESULTS: At all dressing changes the wounds treated with the topical antibiotic appeared moist, while those treated with the silver-based dressings appeared dry. At day 21 all wounds treated with the ointment were completely reepithelialized, while only 55% of those treated with the silver dressing were reepithelialized (p < 0.001). Scar depth at day 28 was also significantly less in wounds treated with the topical antibiotic ointment (4.3 mm vs. 5.1 mm, difference = 0.7 mm; 95% confidence interval [CI] = 0.1 to 1.4 mm). There was less scar contraction in wounds treated with the topical antibiotic compared with the silver-based dressing (mean ± SD = 25.0% ± 14.6% vs. 38.9% ± 16.9%, difference = 13.9%; 95% CI = 5.7% to 22.0%). CONCLUSIONS: In this model of excised deep partial-thickness burns, a triple-antibiotic ointment enhanced reepithelialization and reduced scar depth and contraction compared with a silver-based foam dressing. This triple-antibiotic ointment should be considered as a control for studies evaluating novel topical burn therapies. SN - 1553-2712 UR - https://www.unboundmedicine.com/medline/citation/26202791/Topical_antibiotic_ointment_versus_silver_containing_foam_dressing_for_second_degree_burns_in_swine_ L2 - https://doi.org/10.1111/acem.12723 DB - PRIME DP - Unbound Medicine ER -