A retrospective cohort study of Acticoat™ versus Silvazine™ in a paediatric population

We wished to determine whether changing our centre's practice of using Acticoat™ instead of Silvazine™ as our first-line burns dressing provided a better standard of care in terms of efficacy, cost and ease of use. A retrospective cohort study was performed examining 328 Silvazine™ treated patients from January 2000 to June 2001 and 241 Acticoat™ treated patients from July 2002 to July 2003. During those periods the respective dressings were used exclusively. There was no significant difference in age, %BSA and mechanism of burn between the groups. In the Silvazine™ group, 25.6% of children required grafting compared to 15.4% in the Acticoat™ group (p = 0.001). When patients requiring grafting were excluded, the time taken for re-epithelialisation in the Acticoat™ group (14.9 days) was significantly less than that for the Silvazine™ group (18.3 days), p = 0.047. There were more wounds requiring long term scar management in the Silvazine™ group (32.6%) compared to the Acticoat™ group (29.5%), however this was not significant. There was only one positive blood culture in each group, indicating that both Silvazine™ and Acticoat™ are potent antimicrobial agents. The use of Acticoat™ as our primary burns dressing has dramatically changed our clinical practice. Inpatients are now only 18% of the total admissions, with the vast majority of patients treated on an outpatient basis. In terms of cost, Acticoat™ was demonstrated to be less expensive over the treatment period than Silvazine™. We have concluded that Acticoat™ is a safe, cost-effective, efficacious dressing that reduces the time for re-epithelialisation and the requirement for grafting and long term scar management, compared to Silvazine™.