Delayed use of  polylactide-based copolymer (Suprathel® ) for pediatric partial-thickness burns:
An option for ‘difficult-to-decide’ cases
Ayse Ebru ABALI, Gokhan MORAY, Mehmet HABERAL
Burn and Fire Disasters Institude, Baskent University, Ankara, Turkey

Objectives: Many partial-thickness burns in children lead to confusion whether they are superficial or deep. In this kind of cases optimal decisions are achieved thoroughout post-burn one to three weeks. Polylactide-based copolymer (Suprathel®)  is succesfully used promptly for superficial dermal-burns and following surgical-debridement for deeper ones. This study aimed to document the outcomes of delayed outpatient use of Suprathel® in ‘difficult-to-decide’ cases. Methods: The subjects were 47 pediatric burn-victims who were treated with Suprathel® following outpatient burn wound-care including non-surgical debridement methods(Study-period:2013-2016). Data collected for each case were age, sex, burn-cause, extent of burns, depth of burn-wounds, body-sites affected. Time-intervals between occurrence of injury and admission; time-intervals between admission and Suprathel®application;, time-intervals between occurrence of injury and completion of epithelization were evaluated. Numbers of Suprathel®applications, surgical-debridements, split-thickness-skin-graftings/full-thickness-skin-graftings(STSG/FTSG) and reconstructive surgeries; requirements of physiotherapy/splints were documented(mean±SEM). Results: Mean age was 5.14±0.811(min:0, max:17). Male/female ratio was 0,68/1. Mean total surface area burned was 3.18±0.4%(min:0,5;max:13); it was 2.9±0.4%(min:0,5;max:13) for partial-thickness burns. The most common burn-cause was scalds(72%,n=34). Suprathel® was applied to hands in 18 cases(38,3%), to feet in 15(31,9%), and to genitalia in 2(4,3%). Although head and neck were involved in 14 patients(29,8%), Suprathel®was applied to 2 patients(4,3%). Mean time-interval between occurrences of injury and admission was 1,6±0,36days(min:0;max:10). Mean time-interval between admission and Suprathel®application was 6,5±0,64days(min:0;max:19); mean time-interval between occurrence of injury and completion of epithelization was 17,4±1,08days(min:5;max:34). Suprathel®was applied for once in 31 patients(66%). Eight patients(17%) underwent surgical debridements, 3 of them underwent STSG(1)/FTSG(2). Fifteen patients(31,9%) required physiotherapy, 5 of them used splints. Two patients underwent reconstructive surgery in the long-term. Discussion-conclusions: Outpatient wound-care with non-surgical debridements followed by suprathel® application is a functional option for ‘difficult-to-decide’ partial-thickness burns in childhood. This method seems to prevent exaggerated surgical approaches which may lead to painful and uncomfortable overtreatment courses.

Delayed Use of Polylactide-Based Copolymer (Suprathel®) for Pediatric Partial-Thickness Burns: An Option For 'Difficult-To-Decide' Cases