Early Debridement versus Delayed Debridement in Paediatric Burns and the implications on outcomes

Dr Bronwyn Griffin1, Dr Hamseera  Dave2, Dr  Harry Jin3, Prof Roy Kimble4

1Centre For Children’s Burns And Trauma Research, South Brisbane, Australia, 2Mater Public Hospital, South Brisbane, Australia, 3Royal Brisbane and Women’s Hospital, Herston, Australia, 4Queensland Children’s Hospital, South Brisbane, Australia

Abstract:

Background:

It has been well defined in literature that early excision and grafting for larger burns effectively reduces morbidity, mortality and hospital length of stay for adult burns however little evidence supports the best option for paediatric burns.  This study aims to determine if there is indeed similar advantages in the paediatric population with burns ≥5% total burn surface area (TBSA).

Methods: Patients with superficial or deeper burns that cover ≥5% TBSA from 1st January 2013 to 31st December 2017 were extracted from the Queensland Paediatric Burns Registry and included in data analysis. Cox Regression was utilised to define the risk of delayed days to re-epithelialisation for those not going to theatre within 48 hours of injury.

Results: In total 343 patients were included in analysis,  n=143 patients were taken to theatre at some point and n=49 patients were taken to theatre within 48 hours of injury. Median time to theatre was 66.63 hours (SD=98.87) for all patients and for those within 48 hours, median time to theatre was 15.45 hours (SD=13.67). After adjusting for depth and TBSA%, there was a 33% reduced time to re-epithelialisation for those patients who went to theatre within 48 hours compared to those who didn’t, although not statistically significant (p=0.079), this finding remains clinically relevant.

Discussion: Following these results, additional analysis will be performed to examine the interactions of debridement within 48hours of burn injury and the risk of grafting to further inform the debate of early or delayed debridement in paediatric burns.


Biography:

Dr Griffin has over 10 years’ experience Nursing in paediatric emergency departments across Australia before she first embarked on her PhD with the Centre of Children’s Burns and Trauma Research in 2009. Now Dr Griffin is a Senior Research Fellow based at the Queensland Children’s Hospital where her work supports the integrated spectrum of paediatric burn and trauma care from injury prevention/public health, first aid, acute care and quality of life outcomes.

In her spare time Bronwyn wrangles three school aged children, whom have had no choice but to grow up with a love the bush, books, beaches and baking.

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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