The use of Acticoat TM in neonatal burns R. Rustogi, J. Mill, J.F. Fraser, R.M. Kimble * Royal Children’s Hospital Burns Research Group, The Stuart Pegg Paediatric Burns Centre, Royal Children’s Hospital, Brisbane, Australia Accepted 13 April 2005 Abstract Purpose: To evaluate the safety and efficacy of Acticoat TM use in primary burn injuries and other skin injuries in premature neonates. Procedures: An audit of eight premature neonates who sustained burn injuries and other cutaneous injuries from various agents were treated with Acticoat TM . Serum silver levels were measured in three neonates. Wounds were assessed for infection and blood cultures were taken where sepsis was suspected. Findings: Neonates ranged from 23 to 28 weeks gestation (weight: 578–1078 g). Causative injury mechanisms included: alcoholic chlorhexidine, alcoholic wipes, electrode jelly, extravasated intravenous fluids, artery illuminator, temperature probe and adhesive tape removal. Total burned body surface area ranged from 1 to 30%. All neonates were treated with Acticoat TM dressing changed every 3–7 days. All wounds re-epithelialised by day 28 and scar management was not required. There were four mortalities secondary to problems associated with extreme prematurity. Serum silver levels ranged from 0 to 1 mmol/L. There were no wound infections or positive blood cultures during the treatment period. Conclusions: Acticoat TM is a suitable dressing for premature neonates who have sustained burn injury, with the advantage of minimal handling as the dressing need only be changed every 3–7 days. # 2005 Published by Elsevier Ltd and ISBI. Keywords: Neonate; Acticoat; Burns; Silver 1. Introduction Neonatology in recent years has advanced so that babies as young as 23 weeks gestation are surviving ex-utero. However, with this extreme prematurity comes a unique set of challenges. In a premature neonate, minimal handling can cause hypoxaemia, and over stimulation can cause severe cardiorespiratory decompensation [9]. With immature and thin epidermis prone to injury, thermoregulation is difficult, and the neonate is prone to nosocomial infections [11]. This paper looks at a series of eight extremely premature neonates who sustained burn injuries and other skin injuries from various causes, successfully treated with the nanocrystalline silver dressing Acticoat TM , without requiring scar manage- ment. Acticoat TM is a gauze dressing of silver coated high density polyethylene mesh with a polyester/rayon core. The silver coating is formed by a physical vapor deposition process called magnetron sputtering. The coating film produced is abrasion resistant, non-adherent and flexible, with 0.2–0.3 mg silver/mg polyethylene [14]. 2. Method At the Royal Brisbane and Women’s Hospital’s Neonatal Intensive Care Unit, Brisbane, Australia, between 2002 and 2004, eight premature neonates who sustained primary burn injuries, were managed with Acticoat TM or Acticoat 7 TM , changed every 3–7 days. Low birth-weight (LBW) was defined as weight less than 2500 g, very low birth-weight (VLBW) as less than 1500 g, and extremely low birth weight as less than 1000 g [10]. A preterm neonate is defined as being less than 37 weeks of gestational age. Pre-emptive analgesia in the form of paracetamol via nasogastric tube was given 30 min prior to dressing change. The burn injury was digitally photographed at the commencement of www.elsevier.com/locate/burns Burns 31 (2005) 878–882 * Corresponding author at: Department of Child Health, University of Queensland, Royal Children’s Hospital, Herston, Qld 4029, Australia. Tel.: +61 7 3365 5315; fax: +61 7 3365 5455. E-mail address: royk@uq.edu.au (R.M. Kimble). 0305-4179/$30.00 # 2005 Published by Elsevier Ltd and ISBI. doi:10.1016/j.burns.2005.04.030