None listed
Conditions
Brief summary
Paediatric Hand and Feet burns are a challenging injury for burns clinicians. They have a high prevalence and rate of ongoing morbidity. This is due to a combination of factors including children being curious about their environment and exploring with their hands, having slow withdrawal reflexes and hands and feet having multiple joints within a small body surface area. We believe the management of these burns could be further improved to try and reduce the ongoing morbidity. Currently, standard dressings (mepitel, acticoat and hypafix) are used to dress these burns but there is evidence to suggest that including Negative Pressure Wound Therapy as well may reduce the time to healing and therefore the ongoing morbidity. To include negative pressure as a standard practice of treatment, it must first be shown that it is both feasible and safe. Hypothesis: That the use of NPWT is both feasible and safe in paediatric hand and feet burns.
Interventions
The aim of this study is to contrast the use of standard burns dressings (mepitel, acticoat and hypafix- arm 1); with standard dressings AND negative pressure wound therapy (NPWT) (arm 2).
The specific NPWT we will use is the Renasys Touch. This will involve applying the standard dressings; which is what the control group will receive. In addition, the NPWT group will then have Kerlix and hypafix applied over the top. Film or an EasyDress bag will then be applied over this, a hole cut, a soft
The aim of this study is to contrast the use of standard burns dressings (mepitel, acticoat and hypafix- arm 1); with standard dressings AND negative pressure wound therapy (NPWT) (arm 2). The specific NPWT we will use is the Renasys Touch. This will involve applying the standard dressings; which is what the control group will receive. In addition, the NPWT group will then have Kerlix and hypafix applied over the top. Film or an EasyDress bag will then be applied over this, a hole cut, a soft port applied, the negative pressure canister attached to the port and pressure then delivered. Children will be randomised to an arm using RedCap, and then burns clinicians (either doctors or burns nurses) will apply the dressings as described. A series of photographs, laser doppler images and ultrasound images will be used to assess the progress of burn epithelialisation. Assessing clinicians will be blinded. Mixed method questionnaires will be administered throughout the duration of the study to assess the ability to implement this practice - looking at feasibility, acceptability and appropriateness. Adherence to treatment will be captured by clinic reviews and the feasibility questionnaire. Any patient who fails to attend their appointment will be called to ensure they are not lost to follow up. Who will deliver the intervention: Burns doctors/Nurses with at least 3 years of clinical experience. Mode of delivery: Face to face, provided individually Number of times the intervention will be delivered: NPWT will be applied at the initial time of burn provided nil other treatment has been done; then, it will only be removed between days 5-7 (unless an adverse event occurs, in which case it will be removed, the information around the events logged and standard dressings used). NPWT will not be reapplied after the removal, and the patient will return to standard dressings. Location where the intervention occurs: Queensland Children's Hospital
Sponsors
Queensland Children's Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
No minimum to 16 Years
Healthy volunteers
No
Inclusion criteria
1. Age less than or equal to 16 years of age 2. Must present within 24hours of sustaining a burn injury 3. Any burn that is deep partial thickness or of greater depth on the hand or foot 4. >0.5% TBSA on one hand or foot (ie >1/2 of the hand or foot) and is SPT 5. May be in the context of a larger burn
Exclusion criteria
1. Clinician treatment priority contradicts randomization 2. Do not wish to participate 3. The child is unwell at the time of presentation
Outcome results
None listed