The treatment of paediatric burns with concentrated surfactant gel technology: a case series.

OBJECTIVE: To assess the safety and efficacy of a surfactant-based technology for the management of burns. METHOD: In a retrospective review, paediatric patients with different types of burns were treated with the gel technology. In some patients, the treatment was combined with a topical antimicrobial agent. Primary objectives of the review were the assessment of healing, healing times and ease of use of the material. RESULTS: The wounds of 15 paediatric patients with different types of burns, particularly with regard to depth and anatomical location, were evaluated using a retrospective chart review. It was found that the surfactant gel technology, with or without the topical antimicrobial agent, assisted in autolytic debridement, and that time to re-epithelialisation was short and within the range of those obtained with other established treatments. CONCLUSION: The number of patients and wounds in this evaluation is small but the study indicates that the gel technology provides a safe and effective way to treat smaller burns in paediatric patients.

Effects of a surfactant-based gel on acute and chronic paediatric wounds: a panel discussion and case series.

On 20 November 2018, following the International Society for Paediatric Wound Care conference, a closed panel meeting took place in which the use of a surfactant-based gel (PluroGel (PMM), Medline Industries, Illinois, US) in paediatric wound care was discussed. The authors shared their experiences, thoughts, experimental data and clinical results. The panel identified the need for a product that can gently cleanse paediatric wounds and remove devitalised tissue without causing discomfort or skin reactions, as well as potentially promote healing. In adults, PMM has been shown to assist healing by hydrating the wound, controlling exudate and debriding non-viable tissue. Islands of neo-epithelium have also been reported to appear rapidly in different parts of the wound bed. No adverse effects on these proliferating cells have been observed. In vitro data suggest that PMM can remove biofilm, as well as potentially promote healing through cell salvage. The panel, therefore, set out to discuss their experiences of using PMM in the paediatric patients and to establish a consensus on the indications for its use and application in this population. This article will describe the main outcomes of that discussion and present case studies from paediatric patients with a variety of wound types, who were treated with PMM by members of the panel.

Removal of chest tubes in children without water seal after elective thoracic procedures: a randomized prospective study.

BACKGROUND: Chest tubes are often placed in children after elective thoracic surgical procedures. Depending on surgeon preference, tubes can be pulled directly from suction or after a trial of water seal. Removal of the tube without water seal potentially allows earlier removal, decreased postoperative pain, and earlier discharge from the hospital. No randomized, prospective study has been performed to compare the two methods to determine whether omission of the water seal period is safe after elective thoracic surgery in children. STUDY DESIGN: This is a single-blinded, randomized study conducted between June 1998 and June 2000. Children undergoing elective, noncardiac, nonesophageal thoracic operations were placed into water seal or a nonwater seal groups. Groups were compared for development of pneumothorax or pleural effusion after chest tube removal. RESULTS: Fifty-two children participated in the study, with 28 in group I (suction) and 24 in group II (water seal). Operations included both pulmonary and nonpulmonary thoracic operations performed both thoracoscopically and open. No child developed a major pleural effusion after chest tube removal. Three children (11%) in group I and eight (33%) in group II developed pneumothorax. No child required reinsertion of the chest tube and all were successfully treated with observation and oxygen. There was no marked difference between the groups regarding development of pneumothorax, but the power of the study is low. CONCLUSIONS: A water seal trial is not necessary for safe removal of chest tubes in children undergoing elective surgery. Chest tubes can be removed safely and earlier when pulled directly from suction for both pulmonary and nonpulmonary thoracic pediatric procedures.