Children's Hospital Burns Research Institute

Clinical Research

• Use of Collodial Oatmeal on Healing Paediatric Burns
• Laser Doppler Imaging

Use of Colloidal Oatmeal on Healing Paediatric Burns

Siobhan Connelly

Burn injuries occur worldwide causing major health problems and have a great impact on community resources. The initial stages focus on pain control regimes, however pain often subsides quickly once the healing phase is well underway. Itch on the other hand begins early on in the injury and can continue for weeks, months or even years. Post burn itch is seen as a significant limitation to functional rehabilitation and has been acknowledged as a major area of concern. Itch can have a detrimental effect on the burn area as the fragile outer layer of new skin can easily be scratched away. This project is aimed at addressing the problem of itch in post burn patients. In a study by Matheson, Clayton and Muller in 2001, colloidal oatmeal oil was found to be effective in reducing post burn itch, however, colloidal oatmeal in a moisturising lotion has not been fully evaluated. Therefore a randomised controlled trial has been developed to evaluate whether we are offering the best possible treatment for our patients in regards to moisturisers. Itch also causes problems on the patients psychological healing due to interruptions to normal sleep and activity patterns, causing anxiety and problems with concentration. Thus the project is also aimed at evaluating the effects of the quality of life of burns patients, specifically whether itch has a major affect on it.

Laser Doppler Imaging

A/Prof Andrew Holland, Dr Hugh Martin, Dr Daniel Cass, Dr Erik La Hei

One of the difficulties experienced in managing burn injuries is the diagnosis of burn depth, or predicting burn wound outcome. Superficial burns will generally heal with seven to ten days with very little risk of scarring. In contrast, deep burns take much longer to heal and have a much higher risk of severe scarring, especially if surgical treatment is delayed. Burns surgeons, nurses and allied health staff on the unit have been at the forefront in the development of Laser Doppler Imaging technology in the prediction of burn wound outcome in children. In 2002 fifty-seven patients were prospectively studied over a 10 month period. Each patient was clinically assessed, photographed and independently scanned between 36 and 72 h of the burn. Patients were reviewed until wound healing had occurred within 12 days or skin grafting had been performed. The median age was 1 year and 10 months (range 5 months to 15 years and 8 months). The median body surface area burnt was 7.0% (range 0.5-30%). In 30 patients, the burn did not heal within 12 days, 17 of which were grafted. Clinical examination correctly determined 66% of deep partial or full thickness burns between 36 and 72 h of injury compared to 90% using LDI. The LDI was also more specific; correctly diagnosing 96% of superficial partial thickness burns as opposed to 71% on clinical examination. Moderate degrees of movement did not appear to limit the accuracy of the scan.