Children’s Burns Research Centre

Burns in Children

Dr Amber Youngand Miss Julia Sarginson

The Healing Foundation Children’s Burns Research Centre at the Royal

Bristol Hospital for Children

Evidence Based Care

Children’s Burns Research Centre

The Healing Foundation Children’s Burns Research Centre

www.bristol.ac.uk/childrens-burns

Children’s Burns Research Centre

The scale of the problem:

An estimated 23,000 children present to Emergency Departments in the UK each year with burns and scaldsOver 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 Research Centre

Children’s Burns Research Centre

Common injury patterns:Hot drink scalds

Contact burns: Hair straighteners and irons

Children’s Burns Research Centre

0123456789

1011121314151617

Age

of C

hild

0 20 40 60 80 100TBSA

Sarginson, 2013

All children seen at the South West UK Children's Burns Centre 2010 to 2012

99% of injuries are <20% TBSA

Current research focus

97% of injuries are <10% TBSA

The majority of the published research is on burns of >30% TBSA

Children’s Burns Research Centre

Children’s Burns Research Centre

BURN INJURY <20%

Pain

Distress

Surgery & Scarring

Functional impairment

Illness

Infection

slow healing

Appearance concerns

Small area burn, small problem?

Children’s Burns 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 Dressings2. The MISTIC Study3. 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

Children’s Burns Research Centre

Design: Prospective observational cohort

Population: >28 days, <5 years oldBurn group: <20% TBSA, all mechanisms, all depthsComparison group: Isolated finger-tip crush injury

Duration: 18 month run – Jan 2014 to July 2015

Target recruitment: Burn group: 570 participantsComparison group: 120 participantsTotal: 690.

Children’s Burns Research Centre

Birmingham Children’s Hospital

Due to start Recruiting September

2014

Bristol Royal Hospital for

Children

Recruiting from 13th January

2014

Broomfield Hospital,

Chelmsford

Recruiting from 4th June 2014

Children’s Burns Research Centre

Data Collection1. Prospective information from

medical notes2. Parental Questionnaires3. Parent recorded temperature

diaries4. 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 care2. To identify areas where research and evidence is lacking3. 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