To splint or not to splint: that is the paediatric hand burn pre-operative question?

Mrs Tamsin Mahoney1, Ms Bronwyn Griffin1,2, Mrs Nicole Coghlan1

1Queensland Children’s Hospital, South Brisbane, Australia, 2Centre for Children’s Burns and Research, QUT, South Brisbane, Australia

Abstract:

Introduction

Hands are the most frequent site of burn injury at the Queensland Children’s Hospital (QCH) Pegg Leditschke Children’s Burn Centre (PLCBC). A comprehensive approach to the management of hand burns is essential in minimising the development of contractures and subsequent loss of function (Dewey, 2011; Kowalske, 2011; Moore, 2009).

This study was completed to review the management of hand burn injuries at the QCH PLCBC between January 2015 and June 2018 to improve standardisation of practice amongst Occupational Therapists.

Method

The study involved a 3.5 year retrospective clinical audit obtained from the Queensland Paediatric Burns Registry in combination with critical appraisal of the literature (2008-2018). The search was completed using PubMed, Cinahl, OTSeeker, Cochrane, Google Scholar databases and appraised utilising the McMaster Critical Review Form.

Results

The literature searched revealed that despite splinting being considered an essential part in burn rehabilitation to prevent contractures there is minimal evidence to support its effectiveness (Schouten et al, 2011).

The clinical audit and analysis is currently being completed and will be presented in October.

Discussion

Anecdotally it’s believed that the dressings applied at the QCH PLCBC to hand burns provides a soft splint that allows children to explore their world in a developmentally age appropriate way, engage in usual childhood occupations whilst facilitating muscle pump activity for oedema management.

The purpose of this clinical audit was to explore the incidence of contracture development in the absence of splinting during the acute phase of treatment (i.e. Whilst dressings applied) to assist in developing consistent indicators for intervention.


Biography:

Tamsin Mahoney is a senior Occupational Therapist at the Queensland Children’s Hospital. Tamsin has worked across adult and paediatric tertiary facilities in the area of burns and trauma for more than 10 years.

About ANZBA

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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