Ms Jodie Wiseman1, Dr Robert Ware2, Dr Megan Simons3, Professor Steven McPhail4, Professor Roy Kimble5, Dr Zephanie Tyack1
1Centre For Children’s Burns And Trauma Research, South Brisbane, Australia, 2Menzies Health Institute Queensland, Griffith University, Nathan, Australia, 3Occupational Therapy Department, Queensland Children’s Hospital, South Brisbane, Australia, 4Centre for Functioning and Health Research, Metro South Health, Buranda, Australia, 5Pegg Leditschke Children’s Burns Centre, Queensland Children’s Hospital, South Brisbane, Australia
This study aimed to determine the effectiveness of topical silicone gel and pressure garment therapy, alone or combined, for the prevention and management of burn scarring in children.
A randomised trial was conducted with children with burns that healed spontaneously after 17 days or more, required grafting, or received reconstruction surgery for a pre-existing burn scar. Participants were randomised into: (1) topical silicone gel only, (2) pressure garment only, or (3) combined therapies. Primary outcomes included scar thickness and itch intensity (primary end-point, 6-months post-burn injury). Secondary outcomes included health-related quality of life, scar severity, treatment satisfaction, adherence and adverse effects. Data were analysed using descriptive statistics and mixed models regression.
Participants (N=153; silicone n=51, pressure garment n=49, combined n=53) had a median (IQR) age of 4.9 (1.6, 10.2) years, median percent total body surface area burn of 1% (0.5%, 3%), and were 65% male. At 6-months post-burn injury, intention to treat analysis identified thinner scars in the silicone (n=51 scar sites) compared to the combined group (n=48 scar sites) (MD (95%CI)=-0.04cm (-0.07, -0.00), p=0.05). No other between group differences were identified for outcomes at the 6-months post-burn primary endpoint. Results for the 12-months post-burn secondary endpoint will be discussed.
No benefit was identified for a combined silicone and pressure intervention for the prevention and management of scarring in children at 6-months post-burn injury. Other considerations include the risk of adverse effects and treatment adherence which may underpin treatment selection decisions in paediatric burn-care settings.
Jodie is an Occupational Therapist who has submitted her PhD with the Centre for Children’s Burns and Trauma Research at the University of Queensland and Pegg Leditschke Children’s Burns Centre. Jodie’s PhD research was focused on the effectiveness of silicone and pressure garment therapy for the prevention and management of burn scarring in children.