Ms Christine Andrews1, Ms Margit Kempf1, Prof Roy Kimble2, Dr Leila Cuttle3
1Centre for Children’s Burns and Trauma Research, Child Health Research Centre, The University of Queensland, Brisbane, Australia, 2Centre for Children’s Burns and Trauma Research, Child Health Research Centre, The University of Queensland, Queensland University of Technology, Children’s Health Queensland, Lady Cilento Children’s Hospital, Brisbane, Australia, 3Centre for Children’s Burns and Trauma Research, Queensland University of Technology, Institute of Health and Biomedical Innovation at Centre for Children’s Health Research, Brisbane, Australia
To reduce the risk of a severe burn, understanding the relationship between water temperature and tissue injury severity is essential. Evidence-based injury prediction data is lacking for the temperature of water likely to result in a deep scald injury from a spill/splash event.
Using a porcine scald model, water from 60 to 100⁰C for 5 seconds was tested and the severity of tissue injury investigated. Wound examination, biopsies and Laser Doppler Imaging were performed at 1, 24 hours and at 3 and 7 days post-burn. Burn conditions demonstrating mid-to-deep dermal damage (histologically) were followed for 21 days to assess time to re-epithelialise. Results were compared to burn conditions reported for children with severe scalds requiring split-thickness skin grafts (SSG) by retrospectively reviewing the Queensland Paediatric Burns Registry.
By day 7, water at ≤ 75⁰C showed less dermal damage than 80⁰C or higher, this was statistically significant for scalds ≥ 90⁰C (p <0.05). Damage to ≥ 75% of the depth of dermis was associated with a burn taking longer than 3 weeks to re-epithelialise. A 5 second exposure to water ≥ 85⁰C resulted in burns which remained un-repepithelisied by day 21. Clinically, water was estimated to be ≥ 85⁰C in 74% of cases where a SSG was performed.
Novel evidence-based injury prediction data for accidental spill/splash scalds is presented. Quantitative histological data is translated to the clinically relevant outcome of time to healing and experimental evidence is compared to clinical data describing scald injuries in children.
Christine is a PhD student from the University of Queensland working with the Children’s Burns and Trauma Research group at the Lady Cilento Children’s Hospital. She commenced her studies in May 2014, prior to this she worked as a veterinarian in private practice for over 15 years. Her field of interest is the pathophysiology of burns. Her research examines the relationship between temperature, duration of contact and tissue injury severity for scald burns.