Children's Burns and Trauma Research Group - Projects - Child Health Research Centre

RCT studying three donor site dressings in children (three arms, Sorbact, Cuticerin & Algisite)

Investigator: Dr Craig McBride, PhD Student

Split-thickness skin grafting (SSG) is integral to the management of deep burn injury. SSG involves taking a thin layer of skin from an area of non-injured skin creating a secondary wound (donor site). Patients often report greater discomfort from donor sites than the primary burn injury. There are a number of favourable donor site dressing qualities, as reported by patients and health professionals with pain (including ease of dressing removal), healing time, scar and itch being the most commonly reported.

There is currently no gold standard donor site dressing. Alginates are used extensively as dressings for donor sites. Whilst good in the initial phases, as the wound heals the dressing tends to dry out, adhering to the wound bed, making removal difficult and painful. The optimal donor site dressing should maintain a moist environment and promote rapid healing without adhering to the wound bed.

To compare the effect of Cuticerin (acetate gauze currently used as donor site dressing at RCH, Brisbane), Sorbact (antimicrobial gauze) and Kaltostat (alginate).

CT studying the effect of negative pressure wound therapy (NPWT) in the management of acute paediatric partial thickness burns (two arms, standard dressings with NPWT & standard dressings only)

Investigators: Kristen Storey (Burns Clinical Nurse Consultant) and Dr Bronwyn Griffin

At the Consensus Meeting in Hamburg in 2010 the recommendation of the international Expert Panel that NPWT be applied in the early post-burn phase to halt or limit progression of tissue injury was rejected as only 66% of participants agreed during the consultative phase, as it was felt that the current evidence was not sufficiently robust to make a firm recommendation.

This trial is testing the hypothesis that NPWT by reducing inflammation & oedema will cause a decrease in pain, reduction in time to re-epithelialisation & reduction in scar management requirements.

RCT studying the effect of a hydrogel as an adjunct to cold running water first aid in acute paediatric burns (two arm trial, Burnaid & standard practice)

Investigator: Demi Bertoni, MPhil Student

Ambulance services are using the product frequently with anecdotes to suggest it provides additional analgesia post cold running water (CRW). The product provides additional benefits with its application and ease of transportation to hospital 5. BurnaidTM hydro-gel dressings are sterile open foamed polyester urethane foam that is impregnated with 90% purified water. Following the recognised standard of first aid treatment for acute burns injury CRW for twenty minutes – BurnaidTM is recognised as secondary first aid treatment for acute burns injury; known for its cooling, anti-inflammatory and anaesthetic properties.

RCT on the use of medical hypnosis for paediatric burns dressings (Two arms, medical hypnosis and standard practice)

Investigator: Stephen Chester, PhD Student

Results showed significant decreases in pain and anxiety levels in hypnosis arm children. Children over the age of three respond to medical hypnosis . Hypnosis has been shown to alleviate acute pain associated with a number of painful pediatric medical procedures. Additionally, use of hypnosis has demonstrated a reduction in pain and anxiety associated with venipuncture, bone marrow aspiration, and lumbar puncture in children aged 3 to 8 years. Results have showed significant decreases in pain and anxiety levels in hypnosis arm children. Several members of burn centre due to undergo medical hypnosis training & certification for clinical use.

State-wide RCT on an app based intervention for reducing hot drink scalds (two arms, specific hot beverage scald prevention messages & general injury prevention messages)

RCT studying the use of silicone and pressure garments in children at high risk of burn scars (three arms, silicone gel, pressure garments & both silicone gel and pressure garments)

Validating the relationship between burn temperature, duration of contact and tissue injury depth (laboratory based research with burn models)

Investigator: Christine Andrews, PhD student

Globally, scalds are the most commonly treated paediatric burn injury. However the heat dose (temperature + duration) required to cause a severe deep partial thickness scald injury is unknown. Using modelling, the tissue damage from a burn injury is assessed for scald injury conditions including; immersion and spill/splash scalds. This research will provide valid up to date scientific evidence to inform medicolegal opinions and to guide future scald burn prevention strategies and legislation.

Two RCTs on an early intervention programme for preventing traumatic stress reactions in high risk young injured children (two arms, PTSD intervention program & standard care control)

The psychosocial impact and support needs of Australian young people living with an altered appearance: YP Face IT, an online intervention to promote psychosocial adjustment

Investigator: Caroline Gee, PhD Student

Utilising a mixed-methods design, this study is an Australian first. Semi-structured qualitative interviews will explore the psychosocial impact and support needs of Australian young people who have an altered appearance and the perspectives of health professionals who care for them. The interviews also aim to identify gaps and barriers in service provision and explore attitudes about online interventions. Through an international collaboration with the University of West of England, Bristol, a new online psychosocial intervention called Young People’s Face IT (YP Face IT) will undergo its first empirical testing outside of Europe. Developed by the Centre for Appearance Research (UK), YP Face IT (https://www.ypfaceit.co.uk/index.aspx) is a seven week online intervention, combining cognitive behavioural therapy and social skills training. Designed specifically for 12 to 17 year olds, YP Face IT provides support to young people who worry or are distressed because they have an unusual appearance. The interactive program teaches young people new skills and provide tips to feel more confident about looking “different”, manage difficult social situations, improve self-esteem and reduce appearance anxiety. An acceptability study will determine how culturally suitable YP Face IT is for Australian young people which will inform further feasibility and efficacy testing of YP Face IT in Australia. Findings from this research aim to inform future psychosocial care practices, assist in the development of appearance-related psychosocial resources and support early intervention.

Learn more about this project.

Validating the Brisbane Burn Scar Impact Profile

Investigator: Dr Zephanie Tyack

The Brisbane Burn Scar Impact Profile was developed in 2013 to assess health-related quality of life in people with burn scars. Four separate versions were developed: one for adults, one for children aged 8 to 18 years, one for caregivers of children aged less than 8 years, and one for caregivers of children aged 8 years or older. Preliminary testing has supported the content validity of the Brisbane Burn Scar Impact Profile. However, psychometric testing is ongoing.

Learn more about the Brisbane Burn Scar Impact Profile.

Observations from the paediatric outpatients unit: Parent emotions, behaviour and child distress

Investigator: Erin Brown, PhD Student

Young children are the highest risk age group for incurring burn injuries. A burn injury and the following medical procedures are painful and potentially traumatic, for child and parent alike. Child and parent psychological functioning post-injury is related (De Young et al. 2014), which suggests family dynamics during dressing changes may influence recovery.This research aimed to evaluate the role of parent emotions (i.e. anxiety, depression, posttraumatic stress, guilt) on parenting coping-promoting (e.g. engaging the child in play) and distress-promoting (e.g. restraining the child) behaviours during a dressing change, and the subsequent impact on child distress, pain, and anxiety.

The burden of burns, access to care and functional outcomes in Aboriginal and Torres Strait Islander children in Australia

Although Aboriginal and Torres Strait Islander children in Australia have higher risk of burns compared with non-Aboriginal children, their access to burn care, particularly post-discharge care, is poorly understood, including the impact of care on functional outcomes. The objective of this study is to describe the burden of burns, access to care and functional outcomes in Aboriginal and Torres Strait Islander children in Australia, and develop appropriate models of care.

Children's Burns and Trauma Research Group - Projects