Burns in Children

Evidence Based Care

Dr Amber Young
and Miss Julia Sarginson

The Healing Foundation Children’s

Burns Research Centre at the Royal
Bristol Hospital for Children

Children’s Burns
Research Centre
 The Healing Foundation Children’s Burns
Research Centre

Children’s Burns
Research Centre
www.bristol.ac.uk/childrens-burns
 The scale of the problem:
An estimated 23,000 children present to
Emergency Departments in the UK each year
with burns and scalds
Over 2/3rd are in children under 5 years old

• 60% scald burns (cup of tea)

• 30% contact burns (hair straighteners,
hobs, BBQs, fires)

Children’s Burns
Children’s Burns
Research Centre
Research Centre
 Common injury patterns:
Hot drink scalds

Contact burns: Hair straighteners

and irons

Children’s Burns
Research Centre
 Current research focus
All children seen at the South West UK Children's Burns Centre 2010 to 2012
17
16 99% of injuries are <20% TBSA
15
14
13
12 97% of injuries are <10% TBSA
11
Age of Child

10
9
8
7
6
5
4
3
2
1
0
0 20 40 60 80 100
TBSA
Sarginson, 2013

The majority of the published

Children’s Burns research is on burns of >30% TBSA
Research Centre
 Small area burn, small problem?
Pain

Infection Distress

BURN
INJURY
<20%
Surgery &
Illness
Scarring

Functional
impairment
Appearance
concerns

slow healing

Children’s Burns
Children’s Burns
Research Centre
Research Centre
 Burns in Children

Focussing future research …

Children’s Burns
Research Centre
 Who should we be focussing on?
Common injuries:
• Small burns
• Young children

Children’s Burns
Research Centre
 What should we be focussing on?
• Prevention
• Reduction in infection
• Improvement in scarring appearance
• Improved patient care pathways

Children’s Burns
Research Centre
 Burns in Children

What are we already researching?

Children’s Burns
Research Centre
 Three of our studies:
1. SMART Dressings
2. The MISTIC Study
3. The Paediatric Burns Literature Review
Project

Children’s Burns
Research Centre
 SMART Dressings

Dressings that change

colour in the presence
of infection

Children’s Burns
Research Centre
 Morbidity In Small Thermal Injury in Children

A Prospective Study into the Physiological

Response to Small-to-Moderate Burn Injury,
and the Diagnosis of Early Post-Burn Morbidity,
in Pre-School Children.

Children’s Burns
Research Centre
 Aims:
1) Understand ‘typical’ physiological and
biochemical responses to a small area burn in
pre-school children to define the normal
pathway.
2) Identify risk factors and differentiating
symptoms, signs and biochemical variables to
assist in the diagnosis of post-burn illness –
pathway deviation.
Children’s Burns
Research Centre
 Design: Prospective observational cohort

Population: >28 days, <5 years old

Burn group: <20% TBSA, all mechanisms, all depths
Comparison group: Isolated finger-tip crush injury

Duration: 18 month run – Jan 2014 to July 2015

Target recruitment: Burn group: 570 participants

Comparison group: 120 participants
Total: 690.

Children’s Burns
Children’s Burns
Research Centre
Research Centre
 Birmingham
Children’s
Hospital

Due to start
Bristol Royal
Recruiting
Hospital for
September
Children
2014
Recruiting from
13th January
2014

Broomfield
Hospital,
Chelmsford

Recruiting from
4th June 2014

Children’s Burns
Research Centre
 Data Collection
1. Prospective information from
medical notes
2. Parental Questionnaires
3. Parent recorded temperature
diaries
4. 6 week post-injury follow-up
telephone call

Children’s Burns
Research Centre
Children’s Burns
Research Centre
 Paediatric Burns Literature Review
Project
• Aims:
1. To inform evidence-based care
2. To identify areas where research and evidence is lacking
3. To compare published research in small area burns in children
to other childhood injury and adult burn care

• All published articles on burns in children from 1960s

• Categorisation:
– Topic area / sub-theme
– Type of article or research study
NB – This is not a Systematic Review
Children’s Burns
Research Centre
 Burns in Children

Where next?

Children’s Burns
Research Centre
 Discussion
• Very little evidence based care for this
common childhood injury
• Very little published literature
• Different care pathways across the country
• Varying practice in the management of small
burns and scalds

Children’s Burns
Research Centre
 Acknowledgements

Children’s Burns
Research Centre