Once-daily wound cleansing and dressing change: efficacy and cost.

Children requiring inpatient burn care generally undergo wound cleansing and dressing change twice daily. Each dressing change is associated with significant pain and expense. We explored the efficacy of once- versus twice-daily dressing changes in children with burns of 30% or less of the body surface in a Human Studies Committee approved, prospective, open-label protocol. Fifty children with an average age of 4.4 +/- 4.7 years (range 1 month to 16 years) and an average burn size of 11.2% +/- 8.1% of the body surface (range 1% to 45%) treated with once-daily wound cleansing and dressing change were compared with a matched control group treated twice daily. We noted a significant saving of nursing staff time and a decreased need for pain medication with no change in infectious morbidity, length of stay, or the need for surgery. The patients, parents, and nursing staff were very enthusiastic about the efficacy of the once-daily regimen. This will now become the standard method of managing wounds of this size. We plan to expand the study to burns of 30% to 60%.