Peer-reviewed article
Silver-Impregnated Burn Care Associated With Fewer Painful Dressing Changes and Opioid Doses for Kids.
Jeannette M Joly, Krysta M Sutyak, Thian Nguyen, Macie Boden, Christina Morice et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study compared two types of burn dressings for children with partial thickness burns: antibiotic ointment with frequent changes versus silver-impregnated dressings requiring less frequent changes. Children treated with silver-impregnated dressings needed fewer opioid pain medications and fewer at-home dressing changes, without increasing hospital stays or costs. The findings suggest that silver-impregnated dressings reduce pain and medication burden for young burn patients.
Key points
- Silver-impregnated dressings were associated with 4.5 fewer opioid doses prescribed at discharge compared to antibiotic ointment dressings (5.8 vs 10.3 doses)
- 98% of antibiotic ointment dressing patients required twice-daily changes at home, compared to 97% of silver-impregnated dressing patients requiring changes every 3 days or less
- No significant difference in hospital length of stay between the two dressing types (adjusted risk ratio: 1.04)
- 30-day hospital costs were comparable between groups (adjusted risk ratio: 1.19)
- Use of silver-impregnated dressings increased over the study period from 7% to 52% annually
Limitations
The study is retrospective and cannot establish causation; unmeasured differences between groups or practice changes over time may explain some findings. Clinical outcomes such as infection rates or scarring were not reported.
Abstract
INTRODUCTION: Pediatric partial thickness burn care with antibiotic ointment requires frequent dressing changes with opioid pain management. Alternatively, silver-impregnated dressings are changed less frequently. This study evaluates the association between adoption of silver-impregnated dressings and clinical outcomes and costs. METHODS: A retrospective cohort study was conducted of patients (<16 y) with partial thickness burns (05/2021-07/2024). Patients requiring grafting were excluded. Demographics, burn injury details, dressings, hospital-perspective costs were collected. Patients were grouped by management: short-term dressings (SDs) for antibiotic ointment and nonadherent gauze, long-term dressings (LDs) for silver-impregnated antimicrobial contact layers. Univariate analysis and propensity weighting with linear regressions were used. RESULTS: Overall, 556 patients were treated: 77% with SD, 23% with LD. The median age was 2.7 y (interquartile range [IQR]: 1.3-6.6); 55% were male. Scald burns were most common (70%). Median total body surface area was greater in SD patients (4 [IQR: 2-7] versus 3 [IQR:2-6]; P < 0.05). Over time, the proportion of LD/year increased from 7%-52%. SD patients were prescribed more opioid doses on discharge (10.3 [95% confidence interval [CI]: 9.3-11.2] versus 5.8 [95% CI: 4.6-7.0]) by a mean difference of 4.5 (95% CI: 2.9-6.0; P < 0.001). Post discharge, 98% of SDs required twice-daily changes whereas 97% of LDs required changes every 3 d or less (P < 0.001). There was no difference in length of stay (LOS) (adjusted risk ratio: 1.04; 95% CI: 0.82-1.31), and 30-d costs were comparable (adjusted risk ratio: 1.19; 95% CI: 0.91-1.57). CONCLUSIONS: LD were associated with fewer at-home dressing changes and opioid doses, and were not associated with increased LOS or hospital costs. Children with partial thickness burns should be treated with LD when possible to avoid painful dressing changes.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Adoption of silver-impregnated antimicrobial dressings requiring less frequent changes, compared to antibiotic ointment with nonadherent gauze requiring daily changes
- Population
- Children under 16 years old with partial thickness burns (n=556; median age 2.7 years; 55% male); 77% treated with antibiotic ointment dressings, 23% with silver-impregnated dressings
Key finding
Silver-impregnated dressing patients prescribed mean 4.5 fewer opioid doses at discharge (5.8 vs 10.3 doses; P<0.001)