Donor sites: No big deal or are they?

Stephanie Wicks1, Sharon Welsh2, Elizabeth Anderson1, Loren Hay3, Cheri Templeton1, John Harvey4            

1 Physiotherapist, The Children’s Hospital at Westmead, Locked bag 4001, Westmead 2145,
2 Acting Clinical Nurse Specialist, The Children’s Hospital at Westmead, Locked bag 4001, Westmead 2145
3 Burns Service Registered Nurse, The Children’s Hospital at Westmead, Locked bag 4001, Westmead 2145
4 Department Head, Paediatric Burns Unit, The Children’s Hospital at Westmead, Locked Bag 4001 Westmead, NSW 2145

Donor site morbidity is an often underestimated issue in managing burn injuries requiring skin grafts in the paediatric population. Clinically, delayed healing of donor sites can result in chronic wound breakdown, problematic itch and development of hypertrophic scarring to the donor site area. Management of donor site itch can be particularly challenging in this patient cohort, with habitual scratching leading to cyclic breakdown and delayed closure of wound. This can often result in a more problematic scar to manage than the grafted area itself. This project will aim to identify contributing factors to donor site morbidity by conducting a retrospective review. We plan to critically analyse all patients grafted at a paediatric burns unit in a one year period from January 2015-January 2016. Patients who have had donor sites harvested from the thigh region will be included, reviewing; length of time to healing, complications (such as itch and wound breakdown after initial closure) and presence of a hypertrophic scar at 3 and 6 months post skin grafting. Findings from this study will enable therapists to proactively identify and treat ‘at risk’ donor sites as an element of the patient’s scar management regime. Benefits may include minimising the potential for hypertrophic scarring of the donor site and improving patient outcomes. Further benefits may be experienced through reduction in therapist time, and decreased cost to burns unit.

Key Words

Paediatric Burn, Skin graft, Donor site, Hypertrophic Scar, Physiotherapy, Occupational Therapy


Stephanie is a Senior  Physiotherapist who has worked in paediatric burns for over 6 years at The Children’s Hospital at Westmead. She has an interest in research and optimising the physical recovery of children post burn injury.

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