None listed
Conditions
Brief summary
The ultimate goal of burn wound management is to promote early healing as this has considerable influence on the long term quality and appearance of scarring. Negative pressure wound therapy (NPWT) is a device that is applied to a wound to ultimately help promote healing. It is widely used in both hospitals and the home on a wide range of wounds. A dressing is applied to the wound bed and covered with a transparent film dressing and attached to the therapy device using tubing and a canister. A number of studies have demonstrated improved graft take following split skin graft when NWPT was used compared to standard dressings. However, there is very little information regarding the use of NWPT as a primary treatment for burns with respect to wound progression and pain management. A small number of studies have demonstrated improvement in acute burn wounds with the application of NPWT in the first 48 - 72 hours following injury. In addition, clinically we have seen a reduction in pain with the use of NPWT. The aim of this pilot study is to determine the feasibility of the novel application of NPWT on acute burn wounds. The outcomes of interest being pain, burn wound progression and healing. All children presenting to the Royal Children's Hospital Department of Emergency Medicine with a partial thickness burn injury aged 3 - 15 years of age will be considered for the study. Treating surgical registrars of all children meeting the inclusion/exclusion criteria presenting to the Royal Children’s Hospital, Brisbane will determine eligibility for enrolment in the study. With the parent/caregivers permission an investigator aligned with the study will discuss the study with the parents/caregivers and seek informed consent. Once informed consent is obtained participants will be randomised to one of two treatment groups (standard dressings or standard dressings plus NPWT). Dressings (+/negative pressure depending on group allocation) will be changed at day three post burn injury. Following day three all children will be managed with standard dressings until full re epithelialisation or grafting. Negative pressure will not be reapplied from day three onwards. Outcome measures include burn wound progression measured using laser Doppler imaging on day 0 and day 3, wound healing and pain.
Interventions
Negative pressure wound therapy (Smith and Nephew (TM) Renasys Go)- applied at time of randomisation to intervention group within 12 hours of burn injury and left insitu for three days until first dressing change. From day three onwards all children (regardless of group) will receive standard dressing which for our centre is Acticoat (TM) and Mepitel (TM) secured with hypafix. Feeding tubes are incorporated into the dressing to allow for regular irrigation by parents at home to keep dressing moi
Negative pressure wound therapy (Smith and Nephew (TM) Renasys Go)- applied at time of randomisation to intervention group within 12 hours of burn injury and left insitu for three days until first dressing change. From day three onwards all children (regardless of group) will receive standard dressing which for our centre is Acticoat (TM) and Mepitel (TM) secured with hypafix. Feeding tubes are incorporated into the dressing to allow for regular irrigation by parents at home to keep dressing moist.
Sponsors
Queensland Children's Medical Research Institute, University of Queensland
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
3 Years to 15 Years
Healthy volunteers
No
Inclusion criteria
Children with acute partial thickness burns presenting to the Department of Emergency Medicine, Royal Children’s Hospital aged 3-15.
Exclusion criteria
Age younger than 3 years or older than 16 years Superficial (erythema only) & full thickness burns Burns >10% TBSA Chemical and friction burns Known sensitivity to silver Non English speaking Cognitive impairment Current involvement with Department Communities (Child Safety)
Outcome results
None listed