H.J. van Kempen RN, BHSc, J.Dokter MD, I.M.M.H. Oen MD Burn Centre: nurse and skin therapist⁽¹⁾, medicalcoordinator⁽²⁾, research coordinator⁽³⁾ Medical Centre Rijnmond-Zuid Rotterdam, the Netherlands

Introduction

Itching after burns is a matter of body and mind, but little is known regarding its exact mechanism. Results of studies show a gradual decrease in itch intensity in time, but still moderate to serious itch several years after burns (van Loeye.a. ). In 2006 a gel-creme that supposed to decrease itch was introduced in our Burn Centre. The main ingredients of Alhydran^® are Aloë Vera (Aruba Aloe Barbadenis), vitamins C and E and Jojobaoil. To determine its efficacy we performed a pilotstudy.

Methods

Since November 2006 in the outpatient clinic of the Burn Centre Medical Centre Rijnmond-Zuiditchingisscoredin patients using the Visual Analogue Thermometer (VAT) or the Numeric Rating Scale( NRS 0-10). Measurements were done before application of Alhydran^® and after 1 week, 2 weeks, 1 month and 3 months after the start of treatment. Follow up data were collected on outpatient visit or by phone.

Results

Data analyses with ANOVA and T-test show before starting Alhydran^® that the mean VAT/NRS for itchintensity is 6.7 (see graphic). There is a decrease in time: the mean score after one week is 3.5, after two weeks 3.6, after one month 2.5 and after three months 2.4. There is no relation between VAT/NRS and gender, age, TBSA%, location, cause of burn or combination therapy with other scar treatment. Besides a decreased VAT score parents of young children mentioned their child was more at ease and had a better night’s rest. One patient had discontinued Alhydran^® because there was no itch anymore after 1 week and 1 patient reduced antihistaminic medication. Two patients said they stopped the creme because of irritation of the skin.

Conclusions

“Itching can make you crazy”. Our first experience indicates that this gel-creme could decrease itch intensity after burns, which contributes to improvement of quality of life. On going research will include additional assessment by a Burns Itch Questionnaire, scarevaluation like the Vancouver Scar Scale, Patients and Observer Scar Assessment Scale, cuto – and dermaspectometrie and a Qualiy of Life questionnaire.

Reference⁽¹⁾ NEE van Loey, e.a. Itching following burns; epidemiology and predictors; accepted in Burns 2007.