BACKGROUND: Burn wound re-epithelialisation time has a well-established association with burn depth and scar formation. Scald thermal trauma is the most common mechanism of injury for new patients attending an Australian paediatric hospital and are often responsible for mixed depth burns injuries. Current management options for partial thickness burns include biosynthetic skin substitutes, autologous skin suspensions and silver impregnated dressings. The BRACS trial aims to address the existent clinical equipoise regarding the most ideal dressing, of these three options, in this cohort of children. A comparison of the effect of each dressing on re-epithelialisation time in paediatric superficial partial to mid-dermal thickness burns (primary outcome) and on pain, pruritis, subjective scar severity, scar characteristics, dressing application ease, wound intervention fidelity and health resource utilisation (secondary outcomes) will be completed.
METHODS: This is a three-armed, prospective, single-centre, randomised trial. All new patients (0 – 16 years) presenting with: burns of ≥TBSA 5%, < 48 hours old and burn depth of superficial partial to mid-dermal thickness will be included. Participants (n= 84) will be randomised to one of three groups: Standard silver dressings or Biobrane® with RECELL® or Biobrane®. Initial dressing will be applied under a general anaesthetic and subsequent dressing changes will be every 3-5 days until the wound is > 95% re-epithelialised. Secondary outcomes will be assessed at each dressing change and the 3, 6, and 12 month post-date of injury review. A survival analysis method will utilise time to healing as the main outcome and dressing group as the explanatory variable. Recruitment commenced in May 2018. Ethics has been approved for this project and this trial is prospectively registered with the ANZCTR ACTRN12618000245291.
RESULTS: Nil
CONCLUSIONS: Findings from this study will provide data that potentially identifies the best dressing to optimise re-epithelialisation of paediatric superficial and mid-dermal burns