Pain-Relieving Dressing Allows Trauma Patients to Avoid Surgery

Problem: An otherwise healthy two-year-old girl reached into hot glue, resulting in extensive second- and third-degree hand burns. An otherwise healthy teenaged-boy had a skateboard accident, leaving a full-thickness 2.5cm diameter left medial epicondyle area wound. A healthy middle-aged man dropped the first two fingers of his left hand into a whirling table saw blade, slicing the middle finger from the tip to the first joint and completely shattering the distal phalange of the index finger while nearly severing the fingertip. These trauma patients needed immediate pain relief without incapacitating narcotics so that they could resume their active lives.

Past Management: The girl initially received prescription creams and homeopathic remedies for her burns. Despite acetaminophen+codeine, ibuprofen, and lavender oil, dressing changes (3-4/day) were excruciating. The teenager received oral antibiotics, ibuprofen, and creams, and was referred to a plastic surgeon for debridement. The Emergency Department physician cleaned and loosely sutured the man’s finger wounds, provided narcotic pain relievers, and referred him to a hand surgeon.  

New Approach: Polymeric membrane dressings (PMDs) were designed to decrease pediatric burn patients’ pain by continuously cleansing wounds, being nonadherent, and balancing moisture. They subdue and focus the nociceptor response, which can dramatically relieve pain.

All topical treatments were discontinued, including rinsing at dressing changes, for all three patients. Saturated PMDs were simply removed and replaced. PMDs were provided to patients’ families, who found dressing changes to be pain-free.  

Patient Outcomes: After only 7 hours the girl had clean, unmacerated, uninflamed wound beds. Pain reliever use decreased and healthy granulation tissue formed. All three patients’ wounds closed quickly, without surgical intervention and with minimal scars.

Conclusions: These patients had extremely painful trauma wounds which initially seemed unresolvable without surgical intervention. Through use of PMDs, all three were spared surgery, further pain, and physical and emotional scarring.