Patients with 10 to 20% Superficial partial thickness fresh flame burn will be recruited.
      Burn thickness will be confirmed by using Laser Doppler. After randomly allocating into two
      groups, one group will receive enteral supplemental albumin in the form of boiled egg along
      with routine diet while other group will receive only routine diet.

      Effect of burn healing will be noted in terms of epithelization, oedema, pain and redness and
      days of hospital stay

Effect of Enteral Albumin on Healing of Superficial Partial Thickness Fresh Flame Burns of Adults

Partial-thickness Burn

Burn is an insult to the living tissues typically skin leading to coagulative necrosis due to
      extreme of temperature, electricity or chemicals. Burn injuries are a global public health
      problem with physical, psychological, social and economic implications on patients, their
      families and society as a whole. According to WHO, about 265,000 people die each year due to
      burn injuries. Vast majority of burn cases occur in middle and low socioeconomic groups of
      society. Any age group can be the victim of burn but people belonging to actively working
      class i.e. young adults (18-40yr) are more susceptible to burn injury. The most common sites
      of burn occurrence are domestic kitchen and workplaces from upset of receptacles containing
      hot liquids or directly from flames, electricity or cook stove burst.

      Skin has outer covering of epidermis and deeper one is dermis. Burns, from management point
      of view, can be classified into superficial, superficial partial thickness, deep partial
      thickness and full thickness depending upon the extent of layers of skin involved.
      Superficial burns do not need specialized treatment and heal by their own while deep partial
      thickness and full thickness burns mostly require surgical procedures for management.
      Patients having superficial partial thickness burn wounds are the group of particular
      interest in burn centers due to two reasons. Firstly, the majority of burn injuries fall in
      this group and secondly, these are the wounds which, if managed well, heal in three weeks
      satisfactorily without any surgical intervention. The superficial partial thickness burn
      wounds involve damage to epidermis as well as partial dermis and characterized by Slough
      (yellowish white fibrinous tissue containing proteinacious material, pus and fibrin on wound
      surface), Erythema (redness of burn skin surface), Ooze (excessive fluid loss).

      According to American Burn Association recommendations, patients having superficial partial
      thickness burn more than 10% body surface area need hospitalization for management. Multiple
      factors play role in the healing of superficial partial thickness burn wounds like age,
      co-morbidities (diabetes, HTN, obesity etc), immunosuppressive medications (steroids,
      chemotherapy) and nutritional status. Management of superficial partial thickness burn wound
      requires pain management, dressings, topical ointments and culture guided antibiotics.
      Despite of all these maneuvers, good nutritional support in the form of both micronutrients
      and macronutrients particularly proteins are critical component of acute burn wound care.
      Early optimal nutrition administration in management of burn patients particularly involves
      proteins rich diet due to lot of oozing from large wound surface area, high catabolism of
      muscles and vast tissue repair.

      Protein enrichment of diet, for burn patients, can be achieved by adding albumin, which is
      easily available from many sources especially egg and plays vital role in burn wound healing.
      Albumin, synthesized by liver, is one the major proteins which has several important
      functions. Albumin, composed of essential amino acids, is primary serum binding protein
      required for transportation of various substances in blood circulation. Albumin
      administration is much easier through enteral route. Deficit of albumin occurs due to
      decreased synthesis during inflammatory conditions and, in burns, is further augmented by a
      shift in distribution of albumin to interstitial space from vascular compartment. A
      deficiency of albumin level can impair burn wound healing process whereas increased albumin
      level does not cause significant clinical complication. Hypo-albuminemia caused by wound
      exudation is the major predictor after injury that results in shock induction secondary to
      major extracellular fluid loss by increasing vascular permeability.

      The rationale of this study is to find out effects of albumin supplementation on hospital
      stay by affecting healing of superficial partial thickness burn wounds by.

Albumin supplementation

Wound epithelization will be assessed by photographic image analysis. Serial photographs of wound will be taken on every third day and will be assessed by two independent blinded plastic surgeons to rate for epithelization. The process will be continued till complete epithelization is witnessed.

Pain will be assessed using Numeral Rating Scale (PRS) by score of 10. Score of 0 will be taken as no pain and score of 10 as maximum pain felt ever by the patient. Pain scoring will be done on every third day till complete healing of wound is acheived.

Will be assessed clinically as well as by measuring the girth of the area on every third day and change will be recorded

Traditional group receives diet from hospital kitchen quantity of which calculated depending on calorie requirement per kg body weight. This diet is same for all burn patients fulfilling the inclusion criteria of the study and it will be labelled as routine diet.
Wounds of patients will be managed by closed dressing to be changed on every third day.

Interventional group receiving enteral supplemental albumin 2mg per kg body weight along with routine hospital kitchen diet same as group A and same wound management with closed dressing to be changed on every third day similar to group A.

Effect of Enteral Albumin on Healing of Superficial Partial Thickness Fresh Flame Burns of Adults

About this trial

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Placebo

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