| | In 2001 the staff of the Stuart Pegg Paediatric Burns Centre (SPPBC) at the Royal Children's Hospital formed the Burns Research Group (RCHBRG) with the aim of improving the treatment of children with burns and raising public awareness of burns prevention.
The lifelong consequences of burn injury make it one of the most devastating injuries a child can sustain. Rehabilitation for this kind of injury can often require many visits to hospital to maintain physical function and scar management.
The RCHBRG initiates and conducts clinically relevant cutting edge research, using the most advanced bioinformatics, molecular and cellular biological tools, and in vivo models.
The Group's research has already resulted in a paradigm shift in the way children with burns are treated. Now, less than 5% of all children need to be treated as inpatients (previously 50%) and require dressing changes only once or twice per week instead of daily. They have decreased the rate of skin grafting since 2001 by 43% and reduced the rate of long term scar management by 25%.
This has resulted in better functional, cosmetic and psychosocial outcomes for the children, and has meant considerable cost savings for the hospital.
The development of new treatments to prevent scarring was dubbed the 'Scar Wars' project, and has made significant progresss with identifying proteins and genes which allow the unborn foetus to heal without scars. For some time, it has been understood that surgical skin wounds in unborn babies heal rapidly without scarring. A foetal protein has been identified, and along with other growth factors is being used in pre-clinical assessments in the treatment of burns. The Group will continue to search for other key substances which facilitate rapid wound healing and reduced scarring.
The Group is performing key studies to determine the optimal first aid treatment for burns. these comprehensive studies are the most detailed ever performed, and when completed in 2008, will steer the recommendations for first aid treatment for burns across the world. Common alternative treatments such as aloe vera, tea tree oil, and honey will also be examined for their therapeutic benefits.
Current therapies and dressings are continually evaluated by the RCHBRG both clinically and scientifically. Newly available dressings such as Transcyte(TM) and Acticoat(TM) were compared to traditional dressings, and were found to be cost efficient and more effective for wound healing, reducing the need for grafting and scar management. We are currently evaluating the best techniques for surgical debridement using hydro-surgery, and trialling the use of vacuum-assisted closure (VAC) devices over skin grafts. External funding has enabled the Group to conduct clinical research using virtual reality devices as diversional therapy during distressing dressing changes. A pilot study evaluating this therapy has shown that the therapy reduces anxiety, and improves patient psychosocial outcomes.
Prevention campaigns targeting specific burn mechanisms have been successful in reducing their incidence (eg campfire burns) and won international acclaim. These prevention strategies have been adopted by several countries including USA, Canada and China. RCHBRG works closely with Queensland Fire and Rescue Services, Department of Fair Trading and Kidsafe (Child Accident Prevention Foundation of Australia) to increase public awareness and develop effective campaigns to target particular injury mechanisms.
Digital technology, supported by UQ's Centre for Online Health has enabled clinical members of the RCHBRG to lead the way in both initial treatment and post burn care for patients in regional areas across Queensland, with Telehealth videoconsultations averaging about 300 per year. Telepaediatrics plays a valuable role for clinicians and families of burns patients across Queensland.
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