Keywords
Dressings
Pediatrics
Silver Sulfadiazine
Wound Care
How to Cite
Abstract
Introduction. Pediatric burns are a frequent cause of emergency department attendance and hospitalization and may result in acute pain, infection, delayed healing, and long-term sequelae such as hypertrophic scarring and functional impairment. Early management aims to limit burn progression, optimize the wound microenvironment, and reduce the burden of painful dressing changes for children and families. First aid behaviors and the choice of first-line topical agents and dressings vary widely, and traditional treatments such as silver sulfadiazine have been challenged by newer dressings designed to improve comfort and support outpatient care.
Methods. We conducted a scoping review in accordance with PRISMA-ScR guidance to map evidence on conservative, non-surgical topical agents and dressings used as first-line treatment for minor-to-moderate pediatric burns (age <18 years). We searched PubMed/MEDLINE, Embase, CINAHL, and the Cochrane Library and screened titles/abstracts and full texts in duplicate. We included comparative and non-comparative studies reporting outcomes related to healing, infection, pain, dressing burden, resource use, and scar endpoints. Findings were synthesized descriptively without meta-analysis or risk-of-bias appraisal.
Results. From 2,397 records, 38 studies met eligibility criteria. Designs were heterogeneous (randomized trials, prospective/retrospective cohorts, pilots, observational analyses, and case-based reports) and were conducted across multiple countries. Interventions included first aid and analgesic adjuncts; silver sulfadiazine compared with alternative topical agents and dressings; advanced silver-impregnated systems (eg, hydrofiber/foam dressings); biosynthetic or synthetic membranes and biomaterials (eg, Suprathel®, Biobrane®); hyaluronic acid–based protocols; nanocellulose dressings; gel-based or bioactive treatments; and other innovative dressings. Across comparative studies in superficial-to-partial thickness burns, several advanced dressings were associated with fewer dressing changes and lower procedural pain while achieving comparable or faster re-epithelialization than silver sulfadiazine. Effects on infection, length of stay, and scar outcomes were variable and often limited by inconsistent definitions and follow-up.
Discussion. The mapped literature indicates that selected advanced dressings may provide clinically meaningful advantages by reducing dressing-change frequency and procedural pain, potentially facilitating outpatient management in appropriate cases. However, certainty is constrained by heterogeneity in burn depth assessment, variation in debridement and analgesia pathways, and inconsistent outcome reporting, with limited long-term scar and functional data. Future studies should adopt standardized, patient-centered pediatric outcomes (healing, infection definitions, validated pain/itch measures, and scar assessments) and pragmatic comparative designs to inform internationally applicable care pathways.
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