DACC versus silver gel-forming fibre dressings in paediatric partial-thickness burns: a retrospective comparative study

Objective: Paediatric burns are a major cause of morbidity, with a high risk of infection, complications and poor quality of life. Prompt intervention is indicated to minimise infection and expedite healing. The aim of this retrospective study was to compare clinical outcomes following transition from using gel-forming fibre dressings containing silver (GFFS) to the routine use of dialkylcarbamoyl chloride (DACC)-coated dressings in a tertiary paediatric burns centre. Method: The study followed a retrospective, observational comparative design. Following ethical approvals, clinical outcomes data were extracted from electronic health records of paediatric patients between January and December 2023 during the transition to incorporating DACC-coated dressings into the burn treatment protocols. Results: A total of 63 paediatric patients with burns of various aetiologies were analysed (GFFS group, n=34; DACC group, n=29). Significantly fewer episodes of infection were reported in the DACC group compared to the GFFS group (DACC 20.7% versus GFFS 47.1%; χ 2 p=0.028), combined with less time to infection resolution, while systemic antibiotic requirement was comparable between groups. Persistent infection in four patients in the GFFS group necessitated a change to DACC. These findings aligned with a reduced number of patients with significant bacterial growth (≥10 5 colony-forming units/ml) in the DACC group compared to the GFFS dressing group. No significant difference was reported for surgical debridement requirements and the time to re-epithelialisation; however, overall values were lower in the DACC group. Conclusion: The improved outcomes with DACC-coated dressings, such as reduced rates and duration of infection, shown in this study support re-epithelialisation progression and may reduce the need for systemic antibiotics, ultimately supporting antimicrobial stewardship.