Hydrogel dressing lacks clear analgesic benefit in acute paediatric burns

Hydrogel dressings do little to relieve pain in paediatric burn patients, a study has shown.

A total of 72 children presenting to the emergency department at a tertiary hospital with acute thermal burn were randomized to receive either a hydrogel dressing (n=37) or plasticized polyvinylchloride (PVC) film (n=35) as an analgesic adjunct to first aid.

Pain was assessed using the Face Legs Activity Cry and Consolability (FLACC) Scale at four time points relative to the child’s follow-up treatment: (T1) prerandomized dressing application, (T2) postrandomized dressing removal, (T3) predefinitive dressing application, and (T4) postdefinitive dressing application.

Observational pain scores were comparable between the hydrogel and PVC group at 5 minutes after application of the dressing (T2; mean difference [MD], −0.1, 95 percent confidence interval [CI], −0.7 to 0.5; p=0.72), predefinitive dressing application (MD, −0.3, 95 percent CI, −1 to 0.5; p=0.51), or postdefinitive dressing application (MD, 0, 95 percent CI, −0.8 to 0.9; p=0.92).

Likewise, there were no significant between-group differences seen in child self-reported pain (MD, 0.3, 95 percent CI, −1.7 to 2.2; p=0.78), heart rate (MD, −3, 95 percent CI, −11 to 5; p=0.41), temperature (MD, 0.6, 95 percent CI, −0.13 to 0.24; p=0.53), stress (geometric mean ratio, 1.53, 95 percent CI, 0.93–2.53; p=0.10), or re-epithelialization rates (MD, −1, 95 percent CI, −3 to 1; p=0.26).

The findings do not support the hypothesis that an acute burn dressing with additional cooling and evaporative properties would provide superior pain relief for children with thermal burns when compared with PVC film.