Variation in burn wound management approaches for paediatric burn patients in Australia and New Zealand

Abstract

Background: To date, no large-scale exploration of the profile of, and variance among paediatric patients who underwent a burn wound management procedure in theatre exists in an Australian and New Zealand context. This study aims to provide a profile of paediatric burn patients who underwent a burn wound management procedure in theatre during an acute admission and highlight specific areas of practice where there is variation between burn services that may affect treatment efficacy and efficiency. Methods: We performed a retrospective review of all paediatric patients (ages <16 years) who sustained a burn injury between July 2016 and June 2019 and underwent a burn wound management procedure in theatre, using data from the Burns Registry Australia New Zealand.Results: The number of patients across burn services decreased as TBSA increased. Deep dermal burns represented the majority of cases across services. There was significant variation in time from injury to admission and the proportion of patients who received skin grafts across services. Conclusions: Significant differences in the patient profile and clinical practices were observed among burn services. A greater understanding of the factors underlying the variations at each particular service will also be helpful.

Examining the patient profile and variance of management and in‐hospital outcomes for Australian adult burns patients

“…Similar work in paediatric services is already underway. 17 Since the previous paper from Cleland et al, 14 the BRANZ has undergone refinement to ensure the collected data has clinical relevance and meaning. 15 Significant efforts have been made to provide high-quality training to data collection and entry staff to ensure accurate data entry.…”

“…We hope this paper will act as the required catalyst for further engagement with burn services to optimize impact on clinical measures of interest. Similar work in paediatric services is already underway 17 …”

A Pilot Randomised Controlled Trial Evaluating a Regenerative Epithelial Suspension for Medium-Size Partial-Thickness Burns in Children: The BRACS Trial

“…In cases where the TBSA-B > 5%, management challenges include mitigating the potentially severe morbidity associated with the injuries (e.g., sepsis, severe pain and distress, scar contracture) and the increasing demands for health care resource utilisation at treating centres. In the context of large TBSA-B burns across Australia and New Zealand, less than three percent of children sustain burns greater than 20% TBSA-B [9]. Hence, modern burn wound care is focused on expediting wound re-epithelialisation in which wound closure can be achieved spontaneously using dressings, surgically (by skin graft) or both to optimise outcomes following injury.…”