Autologous skin cell suspensions and Partial thickness Paediatric burns: The BRACS Trial Protocol

Dr Anjana Bairagi1,2, Dr Bronwyn Griffirh1,2, Dr Zephanie Tyack1,3,6, A/Prof Steven  McPhail2,3,4, Prof  Roy  Kimble1,2,5,6

1Centre for Children’s Burns and Trauma Research, Centre for Children’s Health Research, Brisbane, Australia, 2Queensland University of Technology, Brisbane, Australia, 3Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia, 4School of Public Health & Social Work and Institute of Health Biomedical Innovation, Brisbane, Australia, 5Pegg Leditschke Children’s Burns Centre, Lady Cilento Children’s Hospital, Brisbane, Australia, 6University of Queensland, Brisbane, Australia

Abstract:

Background and Aims: Time to re-epithelialisation is associated with scar formation and burn depth(Cubison et al., 2006). At the study site, children most commonly present with scald thermal injuries(Stockton et al., 2015). Management of these often mixed- depth partial thickness burns include silver impregnated dressings, biosynthetic skin substitutes and autologous skin suspensions. The Biobrane®, RECELL® Autologous Skin Cell Suspension and Silver Dressings trial aims to address the existent clinical equipoise amidst these three modalities. This study will compare the effect of each dressing on re-epthelialisation time in paediatric superficial partial to mid-dermal thickness burns (primary outcome) and on pain, pruritis, subjective scar severity, scar characteristics, dressing application ease, wound intervention fidelity, and health resource utilisation (secondary outcomes).

Methods: This is a three-armed, parallel-grouped, prospective, single-centre, randomised trial. New patients (0 – 16 years) presenting with thermal injuries of burn surface area ≥ 5%, <48 hours old and superficial partial to mid-dermal thickness depth will be included. Participants (n= 84) will be randomised to: Standard silver dressings or Biobrane® with or without RECELL®. Initial dressing will be applied under a general anaesthetic and subsequent dressing changes every three to five until the wound is > 95% re-epithelialised. Secondary outcomes will be assessed at dressing change and the three, six and 12-month clinic review. Recruitment started in May 2018.

Conclusions:Findings from this study will provide data to potentially identify the most ideal option that will optimise the re-epithelialisation of paediatric superficial and mid-dermal burns.

Reference:
CUBISON, T. C. S., PAPE, S. A. & PARKHOUSE, N. 2006. Evidence for the link between healing time and the development of hypertrophic scars (HTS) in paediatric burns due to scald injury. Burns, 32, 992-999.
STOCKTON, K. A., HARVEY, J. & KIMBLE, R. M. 2015. A prospective observational study investigating all children presenting to a specialty paediatric burns centre. Burns, 41, 476-83.


Biography:

Anjana is a South African trained Paediatric Surgeon currently working as an Honorary Research Fellow ( Paediatric Surgery ) at the CCBTR and is also a QUT PhD Candidate.