INTRODUCTION:
Ever since man discovered fire he also accidentally burnt himself. India has an ancient culture where the fire is worshipped traditionally. It is probably the potential fury of an unharnessed fire that made man bow before it. Burns are among the oldest injuries that man still suffers from. The burn injury can be one of the most serious and devasting forms of trauma that man can sustain. A burn injury not only destroys the cutaneous barrier but it also leads to profound changes in almost all other organ systems so much so, burn injury has been considered to be the “Universal Trauma Model”.
Millions of people around the world are hospitalized for the treatment of burns each year and thousands die. The daily cost of care for a burn victim is tremendous. The economic loss to any nation is staggering and must be measured not only in currency but in the permanent loss of millions of
productive years. Painful and lengthy hospitalization, multiple stages of surgery, permanent disfigurement and disability, prolonged rehabilitation, loss of income and job and enormous financial burden are some of the horrors looming large over the burn victims.
AIM OF STUDY:
The aim of the study is to compare and analyze the outcome of two methods of Burn Wound Care viz.
1. Open Exposure method vs
2. Closed collagen method (using collagen membrane as temporary cover).
The study and results are being analyzed in terms of
1. Mortality differences,
2. Morbidity differences:
_ Fluid and electrolytes loss.
_ Pain relief.
_ Wound infection.
_ Wound healing and contraction.
_ Duration of hospital stay.
METHODS AND MATERIALS:
This is a prospective clinical trial and the study period extends from 2010 to 2013.
Patient selection:
Of all the burns patients admitted to Thanjavur Medical College Hospital and Rajah Mirasudar Hospital, Thanjavur Medical College, Thanjavur, during the above said period 60 patients were selected based on the following selection criteria and these patients are subjected to this clinical trial.
1. Patients aged 50 years or less than 50 years.
2. Patients having burns of less than 50% TBSA.
3. Patients having no or mild inhalation injury.
4. Patients who do not have any cardiopulmonary compromise.
5. Patients who reached the hospital before the end of 24 hours since injury.
Selected patients were divided into two groups (Group I and Group II) with each group having 30 patients. Each group contained 24 adult patients and 6 paediatric patients.
CONCLUSION:
This study is a small sample clinical trial. The conclusions drawn up here are purely based on the statistical data obtained in the trial. These inferences may need further elucidation by larger clinical trials and follow up.
The comparative analysis of two methods of early burn wound care viz.
1. Open Exposure method vs
2. Closed collagen method – using collagen as temporary cover resulted in the following conclusions.
3. There was no change in the mortality rate of both group patients studied. Mere application of collagen cover to the burn wound did not alter the mortality rate.
4. The pain relief was generally dramatic and continuous in patients treated with collagen membrane as a temporary cover to the burn wound than the patient treated by open method.
5. The need of analgesics, sedatives and anxiolytics was more in patients treated by conventional open method than the patients treated with collagen.
6. Fluid requirement in the form of intravenous fluids during the post resuscitation period was more in patients treated with open method than the patients treated with collagen cover as fluid and electrolyte loss was comparatively less in these patients.
7. Enteral feeding was started comparatively earlier in the collagen group than the patients treated with open method.
8. Burn wound infection was prevalent in all the patients studied but the onset of infection was delayed and intensity of burn wound infection was relatively less in patients studied with collagen than the patient treated by open method.
9. The wound infection should be carefully monitored if collagen is applied as there is always a small risk of hidden submembrane infection, which may be overlooked, posing a danger of severe sepsis.
10. There was no observable change in the healing of First degree burns in both groups. But the healing time was relatively quick following collagen application in the second and Third degree burn areas.
11. Duration of the hospital stay was also comparatively less in patients treated with collagen cover
