Effects of silver sulfadiazine and actilite honey on bacterial wound colonisation and wound healing in children under twelve years with partial superficial burn wounds at University Adult Teaching Hospital in Lusaka, Zambia

Abstract

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 Hospitals (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 honey and SSD on bacterial wound colonisation and wound healing in paediatric partial superficial burn wounds of ≤ 20 per cent TBSA. 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. They were then randomly allocated to either honey or SSD group. Demographics 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. Of the 64 patients, 32 were allocated to each group and showed 1:1 ratio in both groups. 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 difference in bacterial wound colonisation (80% in honey group and 83% in SSD group; p = 0.74). However, by day 10 on treatment, there was significant reduction in bacterial wound colonisation (Honey Vs SSD; P = 0.026). Wounds treated with Actilite® honey healed quicker than those treated with SSD (Mean 11± 4, 15±6, P=0.0049).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 bacterial wound colonisation by day 10. It was further demonstrated that wounds treated with Actilite® honey healed at a faster rate compared to those treated with SSD. Keywords: honey, silver sulfadiazine, burn wounds, wound healing, wound infection