Retrospective audit of burn injuries to lower limbs that require skin grafting in a paediatric population

Miss Crystle Gambetta1

1Lady Cilento Childrens’ Hospital, South Brisbane, Australia


Aim: To report demographics, post-operative management and factors that impact graft take in paediatric lower limb burn injuries that require skin grafting.

Method: This single centre retrospective audit examined the post-operative course for children 16 years or younger who presented to the Pegg Leditschke Children’s Burns Centre, Lady Cilento Childrens’ Hospital over a 27th month period with the above criteria.

Results: Seventy-three children (82 grafts) met inclusion criteria. Median age was 7 years at time of injury (64% male). Forty-five percent of burn injuries were classified as full thickness. The median total body surface area of burn injuries was 2% with 49% of grafts crossing a joint. The median days to theatre was 12 days (IQR=6-14days). Seventy-four percent of children received negative pressure wound therapy, 66% had weight-bearing restrictions and 50% were immobilised in a splint. First change of dressing (COD) following graft occurred at a median of 7 days, at this time the majority of children with prescribed restrictions were cleared to weight bear. Graft take was assessed on the first COD with no clear predictors associated with graft failure. Regraft rate was 6%.

Conclusion: This audit demonstrated a positive outcome of skin grafting for lower limb paediatric burn injuries. Post-operative protocols varied widely throughout the unit with no clear indicators for graft success. Currently there is a paucity of research for early weight bearing in a paediatric population, further studies are warranted to fully explore the impact of this.


Crystle is a Physiotherapist that graduated from the University of Queensland in 2010. Crystle has worked through acute to community settings with ages across the lifespan. In the last 3 years she has worked exclusively in acute paediatric care and most recently moved into a specialised senior role in the critical care, burns and plastics stream. Crystle’s experiences have made her dedicated to holistic clinic practice and family centred care especially for children with complex burn injuries.


ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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