Paradigm Shift in Treatment Strategies for Second-Degree Burns Using a Caprolactone Dressing (Suprathel®)? A 15-Year Pediatric Burn Center Experience in 2084 Patients

Abstract

Background: Thermal injuries represent a highly relevant epidemiologic problem with 11 million individuals affected globally each year, of which around 2.75 million are children. Different approaches to the conservative treatment of second-degree burns have been widely discussed in the existing literature. One method that has attracted increasing attention is the use of caprolactone dressings. This paper describes a study involving the therapeutic management of 2084 pediatric patients suffering from mixed superficial and deep dermal second-degree burns who received comprehensive expert treatment using caprolactone membranes at the pediatric hospital AUF DER BULT. Methods: A retrospective study was conducted to evaluate the frequency and effect of caprolactone membrane usage on children who were admitted to the pediatric hospital between 2002 and 2016 with mixed second-degree burns. The number of dressing changes under general anesthesia and the requirement for split thickness skin grafting were monitored and recorded. In addition, a cost comparison analysis of different treatment modalities was performed. Results: This retrospective study involved 2084 children who had been treated for mixed superficial and deep dermal burns between 2002 and 2016 using either caprolactone dressing (Suprathel®) (study group; n = 1154) or an alternative dressing material (control group; n = 930). Of the patients in the study group, 91.74% (n = 1053) were treated conservatively compared to 76.05% of the control group patients, meaning that 8.26% (n = 101) of the study group patients required skin grafting, compared to 23.95% (n = 223) in the control group. Additionally, the number of procedures under general anesthesia per patient was found to be 54.3% lower among all patients treated with caprolactone dressing (1.75 procedures per patient) compared to the entire control group (3.22 procedures per patient). In the subgroups, patients treated conservatively with caprolactone dressing required 1.42 procedures per patient compared to 2.25 procedures per patient in patients with alternative wound treatment. When split thickness skin grafting was necessary, 1.2 times as many procedures were performed on patients with alternative dressing compared to those treated with caprolactone dressing. Finally, the cost per patient was considerably lower in the conservative therapy group in comparison to the group that consisted of patients undergoing operative therapy with split thickness skin grafting. Conclusions: Caprolactone dressings were found to be beneficial for children who reported with mixed superficial and deep dermal burns. Specifically, they reduced the need for skin transplantation, the number of dressing changes under general anesthesia, and the treatment costs.