How Bad is My Child’s Burn? Differences in Blister Fluid Biochemistry to Assess Paediatric Burn Wounds

Mr Tuo Zang1,2,3, Dr Leila Cuttle1,2,4, Dr Daniel Broszczak1,2,5, Dr James Broadbent1,2,6, Dr Catherine Tanzer1,2,4, Dr Tony Parker1,2

1Tissue Repair and Translational Physiology Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia, 2School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia, 3Wound Management Innovation Co-operative Research Centre, Brisbane, Australia, 4Centre for Children’s Burns and Trauma Research, Queensland University of Technology, Institute of Health and Biomedical Innovation at the Centre for Children’s Health Research, South Brisbane, Australia, 5School of Science, Faculty of Health Sciences, Australian Catholic University, Banyo, Australia, 6Sciex P/L, Brisbane, Australia


Burn blister fluid analysis provides an opportunity to non-invasively investigate the biology of the initial response to burn injury; uncover novel diagnostics or prognostics to assist in clinical decision making and enable the identification of new therapeutic approaches to enhance healing.

We performed a proteomic analysis of 87 paediatric burn blister fluid samples using liquid chromatography – tandem mass spectrometry with SWATH (data independent) acquisition, which allows for the large scale relative quantification of multiple proteins between samples. The blister fluid proteomes of all samples were compared to the key clinical features of burn depth classification and time-to-reepithelialisation. Both of these clinical parameters are critical for enabling accurate clinical decisions regarding early burn treatment options.

Subsequent analyses revealed significant differences in the biochemistry associated with both burn depth and time-to-reepithelialisation. Interestingly, the protein profiles provided evidence of potential clinical misclassification of some burn wounds examined in this study. Importantly, this highlights the utility of diagnostic markers for burn depth and / or prognostic markers of time-to-reepithelialisation. While full-thickness burns are often grafted and superficial-partial thickness burns are often not, it is more difficult to determine if deep-partial thickness burns should be grafted or not. Thus, utilisation of the results of this study could translate to aid in clinical decision making. Overall, this study provides new insights into the early stages of burn wound biology in children and may help with the development of diagnostic or prognostic tools to assist with clinical decisions regarding burn treatment options.


Dr Tony Parker is the program leader of the Tissue Repair and Translational Physiology (TRTP) Program at the Institute of Health and Biomedical Innovation (IHBI) at the Queensland University of Technology. He is also a Senior Lecturer within the School of Biomedical Sciences at QUT. Dr Parker’s research has focused on the biochemical implications of musculoskeletal and skin tissue injury and recovery processes. In particular his team has utilized 2D and 3D in vitro skin wound models and developed the workflows required for the proteomic and metabolomic investigation of wound and tissue fluids. To achieve this he played a key role in the establishment of the world class proteomics and metabolomics capability at QUTs Central Analytical Research Facility (CARF). Dr Parker’s team also has an interest in the health promoting effects of physical activity wherein his team found that moderate levels of exercise in healthy individuals induces the systemic release of the neuroprotective / neurorepairative protein known as the LG3 peptide. This finding may have implications for stroke prevention and rehabilitation and his team is currently exploring the effect of exercise on the release of circulating LG3 peptide in a small clinical cohort.


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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