Dr Anjana Bairagi1,2, Dr Zephanie Tyack1,3,4, Prof Roy Kimble1,2,4, A/Prof Dimitrios Vagenas5, Prof Steven M McPhail3,6, Dr Bronwyn Griffin1,2,7
1Centre for Children’s Burns and Trauma Research, Centre for Children’s Health Research and Pegg Leditschke Children’s Burns Centre, Queensland Children’s Hospital, Children’s Health Queensland Hospital and Health Service,, Brisbane,, Australia, 2Queensland University of Technology, Burns Trauma Research, Centre for Children’s Health Research,, Brisbane,, Australia, 3Queensland University of Technology, Australian Centre for Health Service Innovation and Centre for Healthcare Transformation,, Brisbane,, Australia, 4The University of Queensland,, Brisbane,, Australia, 5Queensland University of Technology, Faculty of Health, Research Methods Group,, Brisbane,, Australia, 6Metro South Hospital and Health Service, Clinical Informatics Directorate,, Brisbane,, Australia, 7National Health and Medical Research Council, Centre of Research Excellence -Wiser Wound Care, Menzies Health Institute of Queensland, Griffith University ,, Brisbane,, Australia
Introduction: Longer time to re-epithelialisation is associated with elevated risk of scarring in childhood thermal burn injuries. Consequently, wound management approaches focus on promoting expedient burn wound re-epithelialisation and minimizing scar-related risk. The BRACS Trial evaluated three dressings in the management of partial thickness burns in children.
Method: All children age ≤ 16years presenting with ≥ 5% total body surface area burns within 48 hours of injury were included. Children were randomised to silver dressings, Spray-On Skin® or Biobrane®. Outcomes measured included time to re-epithelialisation (primary), pain, itch, treatment satisfaction and scar specific health related quality of life at each dressing application up to the primary endpoint of ≥95% burn wound re-epithelialisation and long term follow up to 12 months post injury.
Results: Twenty-two children were assigned silver dressings (n=8), Spray-On Skin® (n=7) and Biobrane® only (n=7). The median time to re-epithelialisation was the same for Spray-On Skin® median=12 (IQR 5.6 – 18.4) days and silver dressings median=12(IQR 3.7 – 20.3) days, compared to Biobrane® median=14(6.3 – 21.7) days. Reduced pain, fewest dressing changes under general anaesthesia and least adverse events were reported in the Spray-On Skin® group compared to the other groups. Secondary outcomes to be presented.
Conclusion: Treatment of paediatric partial thickness burn wounds with Spray-On Skin® resulted in the same re-epithelialisation time as silver dressings (control), and was two days faster than the Biobrane® only group. In addition, burn wounds treated with Spray-On Skin® were associated, in general, with lower number of adverse effect (i.e. wound infections, sepsis, skin graft).
Dr Anjana Bairagi is a paediatric surgeon currently working towards completion of a PhD a in her capacity as an Honorary Research Fellow(Paediatric Surgery) at the Queensland Children’s Hospital, Brisbane, Australia.