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. 2016 Dec 31;29(4):268-272.

Effect of probiotic administration in the therapy of pediatric thermal burn

M H El-Ghazely  1 , W H Mahmoud  1 , M A Atia  1 , E M Eldip  1
Affiliations

Effect of probiotic administration in the therapy of pediatric thermal burn

M H El-Ghazely et al. Ann Burns Fire Disasters. .

Abstract
in English, French

Oral probiotic administration has been advocated for treatment and prevention of a diverse range of disorders. This study was undertaken to evaluate the effect of probiotic supplementation on outcome of pediatric post-burn patients. Forty thermally-injured pediatric patients with total body surface burns between 20-50% and depth between 5-10% were randomized in a prospective, double-blind, controlled clinical trial into two even groups: probiotic group (n=20), who received probiotic preparations, and placebo control group (n=20). Clinical outcomes, including GIT tolerance, incidence of infection, need for grafting, length of hospital stay and mortality were recorded. Laboratory measurements of serum CRP, serum albumin, serum IgA and total lymphocyte count were done upon admission and on days 4, 7 and 14. There were no significant differences between the groups regarding age (3.67 ± 0.67 vs. 3.56 ± 0.73), sex, %BSA (34.5 ± 1.96 vs. 33.9 ± 1.82) and %deep burns (6.95 ± 0.34 vs. 7.25 ± 0.39). Frequency of diarrhea (3 vs. 9), need for grafting (2 vs. 8) and length of hospital stay (17.25 ± 0.5 days vs. 21.9 ± 2.2 days) were significantly lower in the probiotic group (p=0.038, p=0.028 and p=0.044, respectively). A trend towards a decrease in incidence of infections (7 vs. 12) was noted in the probiotic group (p=0.113). There was no mortality in our series. There was improvement in the patients' overall outcome related to wound healing and length of hospital stay following the use of probiotics. However, their effects on infectious morbidity and mortality remain unclear and require further investigation.

L’administration orale de probiotiques a été évoquée pour la prévention et le traitement de pathologies variées. Cette étude a été réalisée pour évaluer l’effet d’une supplémentation probiotique sur l’évolution d’enfants brûlés. Quarante enfants brûlés sur une surface de 20 à 50% (5 à 10% de profond) ont été inclus dans une étude prospective randomisée et répartis en 2 groupes de 20, l’un recevant une préparation probiotique (C), l’autre un placebo (T). Le devenir, la tolérance digestive, l’incidence des infections, la nécessité de greffes, la mortalité et la durée d’hospitalisation ont été colligés. Une mesure de la CRP, de l’albumine sérique, des IgA et un compte lymphocytaire étaient réalisés à l’admission et à J4, 7 et 14. Les groupes étaient comparables en termes d’âge (3,67+/-0,67 ans VS 3,56+/-0,73), de sexe, de surface brûlée (34,5+/-1,96% VS 33,9+/-1,82%) et de pourcentage profondément atteint (6,95+/-0,34% VS 7,25+/-0,39). L’occurrence de diarrhée (3 VS 9), la nécessité de greffe (2 VS 8), la durée de séjour (17,25+/-0,5 jours VS 21,9+/-2,2) étaient significativement moindres dans le groupe C (p=0,038 ; 0,028 et 0,044 respectivement). Dans ce même groupe C, on notait une tendance (p=0,013) vers une diminution des infections (7 VS 12). Aucun patient n’est décédé. Nous avons observé une amélioration de la cicatrisation et une réduction de la durée d’hospitalisation en cas d’utilisation de probiotiques. Toutefois, leurs effets sur la morbidité infectieuse et la mortalité restent flous et nécessitent d’autres études.

Keywords: pediatric patients; probiotics; thermal burn.

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Figures

Fig. 1
Fig. 1. A 5-year-old male with scald burn affecting 40% TBSA, including deep areas 6%. (A) 2nd post-burn day. (B) 14th post-burn day showing acroscopic epithelialization and advancing margin. (C) 22nd post-burn day showing complete burn wound healing.
Fig. 2
Fig. 2. A 2.5-year-old male with scald burn affecting 34% TBSA, including deep areas 8%. (A) 3rd post-burn day. (B) 18th post-burn day showing hypertrophic granulation tissue. (C) 24th post-burn day showing complete graft take.
Table I
Table I. Demographic data (Mean ± SEM)
Table II
Table II. Demographic data (Mean ± SEM)
Table III
Table III. Demographic data (Mean ± SEM)
Fig. 3
Fig. 3. Grafting phase outcome
See this image and copyright information in PMC

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