Study of negative pressure wound therapy as an adjunct treatment for acute burns in children (SONATA in C): a randomised controlled trial

Mr Cody C. Frear1,2,3, Dr. Bronwyn Griffin1,2,3, Associate Professor Leila Cuttle4, Professor  Steven McPhail5,6, Professor Roy Kimble1,2,3

1Centre For Children’s Burns And Trauma Research Children’s Health Research Centre, The University of Queensland, The University Of Queensland, South Brisbane, Australia, 2The Pegg Leditschke Children’s Burns Centre, Queensland Children’s Hospital, Level 5, South Brisbane, Australia, 3The University of Queensland Faculty of Medicine, Herston, Australia, 4Institute of Health and Biomedical Innovation, Centre for Children’s Burns and Trauma Research, Children’s Health Research Centre, Queensland University of Technology, South Brisbane, Australia, 5Centre for Functioning and Health Research, Metro South Health, Queensland Health, Brisbane, Australia, 6School of Public Health & Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia


Background: In the setting of burns, negative pressure wound therapy (NPWT) has been widely adopted as a means of wound bed preparation prior to skin grafting and graft immobilisation. Its role in the treatment of acute burns is less well studied, although there is limited evidence to suggest that it might facilitate physiological healing. This study aimed to assess its efficacy in the management of acute burns in children with small-to-medium-sized thermal injuries.

Methods: A pragmatic randomised controlled trial was conducted in children under 17 years of age with acute thermal burns that covered <5% of their total body surface area (TBSA). Children were excluded if they presented >7 days post-injury, or if their wound was located facially or deemed trivial by clinical staff. Participants were randomised to either an active control consisting of Acticoat and Mepitel or an intervention comprised of Acticoat, Mepitel, and NPWT. Dressings were changed every 3-5 days until ≥95% re-epithelialisation of the wound. The time required to reach this endpoint served as the primary outcome. Secondary outcomes included grafting, pain, ease of management, and scarring at 3 and 6 months post-burn.

Results: A total of 114 children were recruited, of which 57.7% were male. Participants had a median (IQR) age of 3 years (1-8) and TBSA percentage of 1.0% (0.5-3.0%). Results will be presented for time to re-epithelialisation, grafting, and pain.

Discussion: This trial provides evidence-based recommendations for the use of NPWT as an adjunct to standard care in the treatment of acute paediatric burns.


Cody C. Frear is an MD/PhD candidate at the University of Queensland. Prior to starting medical school, he conducted immunology and virology research at the National Institutes of Health in Washington, D.C., and the Biodesign Institute in Tempe, Arizona, inspired by his experiences volunteering at an HIV/AIDS clinic in The Gambia. Following his undergraduate studies, he worked as a medical scribe in an Emergency Department, where he developed an interest in trauma research. This interest led him to the Centre for Children’s Burns and Trauma Research in Brisbane. He is currently completing his PhD, which focuses on the efficacy of negative pressure wound therapy in the management of acute paediatric thermal injuries. His other areas of study include burns first aid and the proteomics of burn wound exudate.


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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