Elsevier

Burns

Volume 31, Issue 7, November 2005, Pages 878-882
Burns

The use of Acticoat™ in neonatal burns

https://doi.org/10.1016/j.burns.2005.04.030Get rights and content

Abstract

Purpose:

To evaluate the safety and efficacy of Acticoat™ use in primary burn injuries and other skin injuries in premature neonates.

Procedures:

An audit of eight premature neonates who sustained burn injuries and other cutaneous injuries from various agents were treated with Acticoat™. Serum silver levels were measured in three neonates. Wounds were assessed for infection and blood cultures were taken where sepsis was suspected.

Findings:

Neonates ranged from 23 to 28 weeks gestation (weight: 578–1078 g). Causative injury mechanisms included: alcoholic chlorhexidine, alcoholic wipes, electrode jelly, extravasated intravenous fluids, artery illuminator, temperature probe and adhesive tape removal. Total burned body surface area ranged from 1 to 30%. All neonates were treated with Acticoat™ dressing changed every 3–7 days. All wounds re-epithelialised by day 28 and scar management was not required. There were four mortalities secondary to problems associated with extreme prematurity. Serum silver levels ranged from 0 to 1 μmol/L. There were no wound infections or positive blood cultures during the treatment period.

Conclusions:

Acticoat™ is a suitable dressing for premature neonates who have sustained burn injury, with the advantage of minimal handling as the dressing need only be changed every 3–7 days.

Introduction

Neonatology in recent years has advanced so that babies as young as 23 weeks gestation are surviving ex-utero. However, with this extreme prematurity comes a unique set of challenges. In a premature neonate, minimal handling can cause hypoxaemia, and over stimulation can cause severe cardiorespiratory decompensation [9]. With immature and thin epidermis prone to injury, thermoregulation is difficult, and the neonate is prone to nosocomial infections [11]. This paper looks at a series of eight extremely premature neonates who sustained burn injuries and other skin injuries from various causes, successfully treated with the nanocrystalline silver dressing Acticoat™, without requiring scar management. Acticoat™ is a gauze dressing of silver coated high density polyethylene mesh with a polyester/rayon core. The silver coating is formed by a physical vapor deposition process called magnetron sputtering. The coating film produced is abrasion resistant, non-adherent and flexible, with 0.2–0.3 mg silver/mg polyethylene [14].

Section snippets

Method

At the Royal Brisbane and Women's Hospital's Neonatal Intensive Care Unit, Brisbane, Australia, between 2002 and 2004, eight premature neonates who sustained primary burn injuries, were managed with Acticoat™ or Acticoat 7™, changed every 3–7 days. Low birth-weight (LBW) was defined as weight less than 2500 g, very low birth-weight (VLBW) as less than 1500 g, and extremely low birth weight as less than 1000 g [10]. A preterm neonate is defined as being less than 37 weeks of gestational age.

Results

The mean gestation at birth was 24.5/40 (range: 23–27.5/40), with a mean birth weight 769 g (range: 578–1078 g), putting these neonates into extremely low to very low birth weight category. Median age at the time of burn was 5 days (range: 1–44 days). Total body surface area burned ranged from 1 to 30%. All neonates were treated with Acticoat dressing, changed every 3–7 days. Out of eight neonates, one suffered chemical burns from alcoholic chlorhexidine (0.5% chlorhexidine plus 70% alcohol) (

Discussion

An ideal dressing used for burn injury should provide antimicrobial cover to minimise the growth of the patient's endogenous bacteria and prevent colonization by nosocomial organisms. It should promote healing and minimize discomfort associated with dressing care, whilst being cost-effective to the patient and the health care system [14]. Such desired attributes of a dressing are no more pertinent than in the care of premature neonates.

In this series all neonates were of less than 27 weeks of

References (16)

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