Clinical Evaluation Comparing the Efficacy of Aquacel Ag with Vaseline Gauze versus 1% Silver Sulfadiazine Cream in Toxic Epidermal Necrolysis

OBJECTIVE: The purpose of this study was to determine whether using Aquacel Ag (ConvaTec, Skillman, New Jersey) with Vaseline (Unilever, London, England) gauze instead of silver sulfadiazine cream (SSD) as the wound care protocol to treat toxic epidermal necrolysis (TEN) can improve wound healing, pain control, and reduction of labor costs. DESIGN: A retrospective chart review. SETTING: A burn center with 2 plastic surgeons and 11 nursing staff. PATIENTS: A pathologist diagnosed TEN in 35 patients admitted to the burn center from 1995 to 2009. MAIN OUTCOME MEASURES: Parameters included the patient's profile, dressing choice, severity-of-illness score for TEN, time to 95% re-epithelialization, visual analog scale pain scores before second dressing change, and labor cost. The exclusion criterion was wound care with neither Aquacel Ag with Vaseline nor SSD exclusively. RESULTS: Twenty patients were enrolled in this study. In the group using Aquacel Ag with Vaseline gauze, the visual analog scale score was significantly less than that of the SSD group (P = .02). Labor costs were significantly lower in the Aquacel Ag with Vaseline gauze group (P < .01). Commencement of specific dressing to 95% re-epithelialization (P = .09) and time spent in the second dressing change (P = .05) had no statistical significance between the 2 groups. CONCLUSIONS: This study showed that Aquacel Ag with Vaseline gauze decreased pain and labor costs but did not shorten wound healing time. Thus, Aquacel Ag with Vaseline gauze can be an efficient method for treating TEN wounds.