Effects of silver sulfadiazine and Actilite® honey on bacteria wound colonisation and wound healing in children with partial superficial burn wounds at University Teaching Hospital, Lusaka, Zambia

Abstract

Background: Burn wounds are a global public health concern and Zambia has not been spared. Burn wounds account for 6% of surgical admissions yearly and yet are amongst the common causes of mortality at University Teaching Hospital (UTH). Burn wounds seen at UTH affect children more than adults and the common size is £20 per cent and partial superficial thickness in depth. The hospital has no burns unit and as such patients are admitted in general wards where cross infection is not uncommon. With high infection and mortality rates at UTH this study is of importance as it examined the effects of Actilite® honey and Silver sulfadiazine on bacteria wound colonisation and wound healing in paediatric partial superficial burn wounds of £20 per cent total body surface area. Methods: This two-arm open label randomised trial was done at UTH over a period of seven months (July 2017-January, 2018). Children under twelve years with £20% partial superficial burn wounds were recruited. Simple randomisation was used to allocate patients to either honey or SSD group. Patients' clinical characteristics were noted on recruitment. Swabs for microbiological evaluation  were collected on day 0, 3, 7 and 10 and wounds were assessed for healing. The University of Zambia Biomedical Research and Ethics Committee approved the research. Results: Of the 64 patients, 32 were allocated to each group. The modal age distribution was 1-2 years and the percentage burn wound surface area was 6-10 percent in both age groups. At baseline there was no significant association between the two treatment methods and bacterial wound colonisation (80% in honey group and 83% in SSD group; p = 0.74) using Chi-squared test. However, by day 10 on treatment, there was significant reduction in bacterial wound colonisation (Honey Vs SSD; P = 0.026). Using Student T-test it was found that wounds treated with Actilite® honey healed quicker than those treated with SSD (Mean 11± 4, 15±6, P=0.0049).  Conclusion: The study showed that treatment of children under 12years with partial superficial burn wounds of £20 per cent  TBSA using Actilite® honey significantly reduced levels of bacteria wound colonisation by day 10. Furthermore, wounds in the Actilite® honey group healed quicker than SSD group. Therefore, use of Actilite Honey on burn wounds could be explored as alternative to SSD in managing paediatric partial superficial burn wounds of 20% and below at UTH.