Donor site scarring – An algorithm for early intervention

Mrs Claire Toose1, Miss Stephanie Wicks1, Ms Elizabeth Anderson1, A Prof John Harvey1

1Children’s Hospital at Westmead, Westmead, Australia

Donor site morbidity is an often underestimated issue in managing burn injuries requiring skin grafts in the paediatric population. A retrospective review conducted by our unit of all donor sites harvested in a one year period from January 2015 – January 2016, identified several factors that appear to play a causal role in moderate to severe scarring of donor sites: Asian or African ethnicity; TBSA >6%; presence of donor site infection; and number of days to heal.

In the second phase of this project, we have used the analysis and findings of this review to develop an algorithm to guide clinical decision making with regard to the identification and management of donor site scarring. The aim of this algorithm is to ensure patients at risk of moderate to severe donor site scarring are identified early, monitored appropriately and receive early scar management treatment if required. The hope is that the incidence of moderate to severe donor site morbidity can be reduced by the implementation of a structured process that facilitates early intervention and ensures all patients are screened for their level of risk.

Claire is one of the Senior Burns Physiotherapists at The Children’s Hospital at Westmead. She works in both the acute management and long term rehabilitation of children following burns injury, trauma and plastic surgery.

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