Open versus Closed Sandwich Wound Dressing Method in Burn Children

Background: Open method of dressing burn wounds has been the accepted mode of burn wound care in most of our hospitals. Closed dressing has been shunned because of the belief that it is costly and labour intensive.
Methods: A retrospective study was conducted on 170 children under 12years admitted to the Pediatric surgical/female burn ward between the months of June 2006 to March 2007. A comparison was made between the open and closed sandwich method of burn wound dressing. The sandwich method entailed using 17 by 17cm square pieces of gauze with a layer of cotton in between. The dressing was left on for between 3 and 4 days. The open method was used on 92 patients (Group A) admitted between the months of June 2006 to October 2006, while the closed method was applied on 78 patients (Group B) admitted during the months of November 2006 to March 2007.The demographic data of the two groups were analyzed. The duration of hospital stay, fatalities and proportion of patients discharged were used as outcome indicators for the two groups.
Results: The male to female ratio was found to be 1.4:1 for Group A and 1.5:1 for the Group B. The majority of burn wounds were caused by scalds with children under five being the most affected in both groups (81.5% and 85.9% respectively). Most of the burns in the two groups were less than 10% of the body. The results of outcome indicators showed no statistical differences between the two groups.
Conclusion: Sandwich closed dressing changed every after three to four days does not adversely affect outcome of burn patients. This type of dressing is recommended for health facilities with limited resources since it reduces the burden on the nurse and also the cost of dressing materials while providing the benefits of closed dressing.