Abstract | March 2, 2021
Early Application of a Water-soluble Surfactant Dressing for Partial-thickness Burn Wounds to Reduce Wound Conversion
Learning Objectives
- Summarize the potential for surfactant-based dressings to reduce partial-thickness burn wound conversion;
- Design a wound care plan to implement early application of surfactant-based dressings to reduce patients’ operative burdens.
Introduction: Surfactant-based wound dressings have been utilized in chronic, non-healing wounds and small burn wounds to soften and aid removal of wound debris.1 In vitro data suggest enhanced healing properties are due to the ability to stabilize and potentially reseal plasma membranes, thereby, retaining cellular integrity and enhance wound healing.2 Further, surfactant-based wound dressings are non-ionic and may facilitate removal, sensitize, or prevent bacterial biofilms.3,4 Biofilms are an evolved, protective mechanism bacteria utilize to reduce antimicrobial efficacy. Removal or penetration of biofilms is essential for bacterial eradication. There is little evidence supporting the early use of a water-soluble surfactant dressing (WSD) for treating partial thickness burn wounds.
Methods: The study was a retrospective, single-center, electronic health record review. Patients were included if they are admitted between August 1, 2019 and January 31, 2020, at least 18 years old, and sustained a partial-thickness burn wound that was treated with a water-soluble surfactant dressing on admission. Patients were excluded with they were pregnant or incarcerated.
Results: Thirty-two patients were included. All but one patient had a total body surface area burn less than 20% with median (IQR) of 6% (3.5,9). The WSD was applied on admission, following initial cleansing, and then twice daily until either discharge or it was deemed burn wound excision would be required. The majority of patients had multiple comorbidities known to impede wound healing, yet most healed without significant wound conversion. The WSD was well tolerated and no patients developed a wound infection to the applied area.
Conclusion: The case series demonstrates feasibility of early application, and efficacy preventing wound conversion in a complex population with comorbidities and polysubstance abuse. A randomized-controlled study is warranted to see if early application of WSD may improve healing and reduce incidence of burn wound conversion and infections.
References and Reosurces
- Palumbo FP et al. New Surfactant-based Dressing Product to Improve Wound Closure rates of Nonhealing Wounds: A European Multicenter Study Including 1036 Patients. Wounds. 2016;28(7)233-240.
- Chen R et al. In vitro cellular viability studies on a concentrated surfactant-based wound dressing. Int Wound J. 2019;16:703-712.
- Yang Q et al. A surfactant-based wound dressing can reduce bacteria biofilms in a porcine skin explant model. Int Wound J. 2017;14:408-413.
- Salisbury A and Percival SL. Efficacy of a surfactant-Based Wound Dressing in the Prevention of Biofilms. Adv Skin Wound Care. 2018;31:514-520.
