Implementation of negative pressure for acute pediatric burns (INPREP): A stepped-wedge cluster randomized controlled trial protocol.

Background: Acute application of adjunctive negative pressure wound therapy (NPWT) significantly improves time to re-epithelialization in pediatric burn patients. This adjunctive treatment has not yet been broadly or routinely adopted as a standard primary burns dressing strategy. The Implementation of Negative PRessurE for acute Pediatric burns (INPREP) trial will implement and evaluate the impact of adjunctive NPWT in parallel with co-designed implementation strategies and resources across four major pediatric hospitals.

Acceptability and Usability of Smileyscope Virtual Reality for Paediatric Pain Management During Burn Procedures: Perspectives of Patients, Carers and Clinicians.

Aim: To explore clinician, child and parent acceptability and usability of the Smileyscope VR device in the context of addressing the unique pain and distress needs of young burn patients.

Design: A survey comprising closed and open-ended questions.

Method: Descriptive statistics analysed participant characteristics, pain and analgesia.

Examining the impact of a paediatric trauma family support service on the quality of life of injured children: A longitudinal cohort study.

Purpose: We describe and evaluate the introduction of a trauma family support service (TFSS) in an Australian tertiary paediatric hospital.

Design And Methods: A longitudinal mixed-methods cohort study evaluated the effectiveness of the TFSS on quality of life. PedsQL4.

Ultrasound measurement of traumatic scar and skin thickness: a scoping review of evidence across the translational pipeline of research-to-practice.

Objectives: To identify the ultrasound methods used in the literature to measure traumatic scar thickness, and map gaps in the translation of these methods using evidence across the research-to-practice pipeline.

Design: Scoping review.

Data Sources: Electronic database searches of Ovid MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature and Web of Science.

Inflammatory proteins and neutrophil extracellular traps increase in burn blister fluid 24h after burn.

Burn wound blister fluid is a valuable matrix for understanding the biological pathways associated with burn injury. In this study, 152 blister fluid samples collected from paediatric burn wounds at three different hospitals were analysed using mass spectrometry proteomic techniques. The protein abundance profile at different days after burn indicated more proteins were associated with cellular damage/repair in the first 24 h, whereas after this point more proteins were associated with antimicrobial defence.

Unremitting pro-inflammatory T-cell phenotypes, and macrophage activity, following paediatric burn injury.

Objectives: The aim of this study was to characterise the dynamic immune profile of paediatric burn patients for up to 18 months post-burn.

Methods: Flow cytometry was used to measure 25 cell markers, chemokines and cytokines which reflected both pro-inflammatory and anti-inflammatory immune profiles. Peripheral blood mononuclear cells from 6 paediatric burn patients who had returned for repeated burn and scar treatments for > 4 timepoints within 12 months post-burn were compared to four age-matched healthy controls.

Effectiveness of a Regenerative Epithelial Suspension (RES), on the pigmentation of split-thickness skin graft donor sites in children: the dsing pilot randomised controlled trial protocol.

Background: Paediatric donor site wounds are often complicated by dyspigmentation following a split-thickness skin graft. These easily identifiable scars can potentially never return to normal pigmentation. A Regenerative Epidermal Suspension (RES) has been shown to improve pigmentation in patients with vitiligo, and in adult patients following a burn injury.

Tissue Pressure Changes and Implications on Dressing Selection when utilising Negative Pressure Wound Therapy on an Ex Vivo Porcine Model.

Negative Pressure Wound Therapy (NPWT) is broadly used in surgical wound management and more recently burn care; however, the tissue pressure changes and best dressing application technique remains unknown. This study was done to help understand the tissue pressure changes beneath negative pressure when varying the delivered pressures, dressing thickness and distribution of dressings. This study was done in 2021 at a quaternary paediatric burns hospital.

Co-design of a paediatric post-trauma electronic psychosocial screen.

Purpose: To optimise care pathways and provide greater transparency of the psychosocial needs of injured children after hospital discharge by extending post-discharge psychosocial screening to children admitted with traumatic injury for ≥24 h.

Design And Methods: This mixed-methods study used a co-design approach informed by the Experience-Based Co-design (EBCD) framework. Interviews with carers were used to evaluate experiences and generate views on psychosocial support interventions.

Redefining hypnosis: A narrative review of theories to move towards an integrative model.

Hypnosis is an ancient mind-body intervention that has regained interest with the surge of research in the last decade documenting its clinical validity. Yet, theoretical controversies and misconceptions prevail among theorists, clinicians, and the general public, impeding the understanding, acceptance, replication, and use of hypnosis. Providing adequate information, which dispels misconceptions and promotes more balanced views, is warranted to facilitate the implementation and adoption of hypnosis in clinical and research settings.

Barriers and facilitators to burn first aid practice in the prehospital setting: A qualitative investigation amongst emergency medical service clinicians.

First aid cooling for burn injuries improves re-epithelialisation rates and reduces scarring. The objective of this research was to explore and describe barriers and facilitators to the provision of optimal first aid for acute burn patients in the prehospital setting. Emergency medical service (EMS) clinicians in Queensland were invited via email to participate in a survey designed to assess experience, knowledge, and attitudes regarding provision of optimal burn first aid in the prehospital setting (N = 4500).

Demystifying hypnosis: Unravelling facts, exploring the historical roots of myths, and discerning what is hypnosis.

Background And Purpose: Hypnosis, a mind-body treatment dating back to early human history, has regained attention in the last decade, with research suggesting its effectiveness for varied physiological and psychological ailments such as distress, pain, and psychosomatic disorders. However, myths and misconceptions have prevailed among the general public and clinicians, hindering the adoption and acceptance of hypnosis. It is important to distinguish myths from facts and discern what is hypnosis and what is not to enhance the understanding, acceptance, and adoption of hypnotic interventions.

The feasibility of negative pressure wound therapy versus standard dressings in paediatric hand and foot burns protocol: a pilot, single-centre, randomised control trial.

Introduction: The goal of paediatric hand and foot burn management is hypertrophic scar and/or contracture prevention. The risk of scar formation may be minimised by integrating negative pressure wound therapy (NPWT) as an acute care adjunct as it decreases the time to re-epithelialisation. NPWT has known associated therapeutic burden; however, this burden is hypothesised to be outweighed by an increased likelihood of hypertrophic scar prevention.

Protocol for a feasibility, acceptability and safety study of the PICO device (negative pressure wound therapy) in acute paediatric burns.

Introduction: Negative pressure wound therapy (NPWT) in acute burn care may decrease the time to re-epithelialisation by more than 20%. Despite this, the perceived burden of use; including therapeutic, physical and financial, have limited the use of NPWT in acute burn care. This might be minimised by using the small, ultraportable, single-use NPWT device PICO as opposed to larger devices, which to date has never been studied in acute burn care.

In-hospital outcomes of paediatric burn injuries managed in children's hospitals compared to general hospitals.

Introduction: In Australia and New Zealand, children with burn injuries are cared for in either general hospitals which cater to both adult and paediatric burn injuries or in children's hospitals. Few publications have attempted to analyse modern burn care and outcomes as a function of treating facilities.

Aim: The aim of this study was to compare in-hospital outcomes of paediatric burn injuries managed in children's hospitals to those treated in general hospitals that regularly treated both adult and paediatric burn patients.

A Pilot Randomised Controlled Trial Evaluating a Regenerative Epithelial Suspension for Medium-Size Partial-Thickness Burns in Children: The BRACS Trial.

Background: There is little evidence regarding the efficacy of Regenerative Epidermal Suspension (RES™) management for paediatric partial-thickness burns. The Biobrane RECELL Autologous skin Cell suspension and Silver dressings (BRACS) Trial evaluated three dressings for the re-epithelialisation of partial-thickness burns in children.

Methods: Eligible children (age ≤ 16 years; ≥5% TBSA; ≤48 h of injury) were randomised to silver dressings, RES™/Biobrane or Biobrane.

Becoming Experts in Their Own Treatment: Child and Caregiver Engagement With Burn Scar Treatments.

Children who experience a severe burn injury not only require acute medical care but may also need ongoing rehabilitation. To mitigate the potential long-term consequences of scarring and the impact of scarring on their everyday lives, children may be expected to use a variety of time-consuming and multi-component non-invasive scar treatments (such as pressure garments and silicone gels). These treatments may pose unique challenges for children and their caregivers.

Local burn wound environment versus systemic response: Comparison of proteins and metabolites.

In this study, paired blood plasma (BP) and blister fluid (BF) samples from five paediatric burn patients were analysed using mass spectrometry to compare their protein and metabolite composition. The relative quantification of proteins was achieved through a label-free data independent acquisition mode. The relative quantification of metabolites was achieved using a Shimadzu Smart Metabolite Database gas chromatography mass spectrometry (GCMS) targeted assay.

Clinical Hypnosis for Procedural Pain and Distress in Children: A Scoping Review.

Objective: Pain and distress are common in children undergoing medical procedures, exposing them to acute and chronic biopsychosocial impairments if inadequately treated. Clinical hypnosis has emerged as a potentially beneficial treatment for children's procedural pain and distress due to evidence of effectiveness and potential superiority to other psychological interventions. However, systematic reviews of clinical hypnosis for children's procedural pain and distress have been predominantly conducted in children undergoing oncology and needle procedures and are lacking in broader pediatric contexts.

Cost-effectiveness of scar management post-burn: a trial-based economic evaluation of three intervention models.

Optimal burn scar management has the potential to markedly improve the lives of children, but can require substantial healthcare resources. The study aimed to examine the cost-effectiveness of three scar management interventions: pressure garment; topical silicone gel; combined pressure garment and topical silicone gel therapy, alongside a randomised controlled trial of these interventions. Participants were children (n = 153) referred for burn scar management following grafting, spontaneous healing after acute burn injury, or reconstructive surgery.

The effect of 20 minutes of cool running water first aid within three hours of thermal burn injury on patient outcomes: A systematic review and meta-analysis.

Background: Burn injuries are a leading cause of morbidity that can result in devastating disability and poor quality of life for survivors. This systematic review aimed to synthesise evidence regarding the effect of 20 minutes of cool running water (CRW) within three hours of injury on outcomes of patients with thermal burn injuries.

Methods: This systematic review was conducted in reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Diphallia: literature review and proposed surgical classification system.

Background: Diphallia occurs once in 5-6 million births, with no two patients presenting with the same anatomical variation. Here we discuss a review of diphallia case reports, as well as present a new surgical classification system based on the soft tissue composition of the two phalluses, the anatomy of the urethra present within the most normal phallus and the bladder configuration.

Methods: Eighty-seven diphallia case reports were collected and analysed, excluding those presented in animals and articles that were non-English, with the results compiled to provide an in-depth reference of the specific anatomy found in diphallia patients and the associated abnormalities.