Dr Dharshini Selvarajah1, Professor John Harvey1, Dr Susan Jehangir1, Ms Julie Jones1, Ms Sharon Welsh1, Ms Madeleine Jacques1
1The Children’s Hospital Westmead, Sydney, Australia
Background:Advances in burns dressings, surveillance with early detection of bacterial colonisation and the appropriate use of antibiotics, has significantly reduced the incidence of graft loss, improved healing and reduced scarring in burns. The aim of this study is to determine the influence of bacterial colonisation and the use of antibiotics on graft take in minor burns (<10% total body surface area).
Methods:A retrospective review was undertaken of all children with minor burns who underwent skin grafting at The Children’s Hospital at Westmead (CHW) between April 2017 and April 2018. The presence of bacterial colonisation of the burn wound, the use of antibiotics, and the result of skin grafting was determined from the medical records.
Preliminary Results (5 months):
Of 59 children with burns who required grafting during the study period, 24 (40%) patients were identified to have bacterial colonisation. Complete graft take was higher in the non-colonised group compared to the colonised group; 35 (100%) vs 17 (71%), p=0.0010.
Of the 24 colonised children, 18 (75%) received antibiotics. Of these there was complete graft take in 15 (83%). Graft loss occurred in 3 (16%). Of 6 who did not receive antibiotics, there was complete graft take in 2(33%) and graft loss in 4 (66%). Complete graft take was higher in the antibiotic group compared to the non- antibiotic group, p=0.038.
Conclusions:Bacterial colonisation has a significant effect on graft outcomes. Timely use of appropriate antibiotics to treat bacterial colonisation can improve graft outcomes in minor burns.
Dr Dharshini Selvarajah – Burns Registrar from the Children’s Hospital Westmead