Leading the way in burns care

Article from 2019/2020 Impact of Giving Annual Report

To say the RCH Burns Unit is a busy place is an understatement. As the designated statewide burns centre for paediatrics in Victoria, a team of surgeons, nurses, physiotherapists, occupational therapists, child-life therapists, social workers, prosthetists and anaesthetists treat around 600 new burn cases annually, ranging from minor and common wounds to severe and debilitating burn injuries.

Through the incredible support of transformative gifts in Wills from individuals including Marjorie Tivendale and Laurie Davies, the Burns Unit is set to change the  way it cares for some of the most high-needs patients. Already a world leader in the provision of clinical care for burns, philanthropic support means the multidisciplinary team will be able to provide an even more comprehensive and holistic service to children and their families through the development of a research program and improved technology.

“Marjorie and Laurie’s gifts have empowered our team to think bigger, and further into the future than we ever have before. Thanks to their support, we have been able to establish the position of an Academic Burns Surgeon to expand our team’s research capabilities. We will also be able to purchase new laser technology in the form of a fractional ablative CO2 laser. Already in use in other states, the laser will be the first of its kind in Victoria used for children’s burns,” said Associate Professor Warwick Teague, Director of the Trauma Service and Clinical Lead for the Burns Unit.

Burns care and management has changed dramatically over the past decade, with many advancements being made in the understanding and treatment of burns. Whilst this has had a positive impact by decreasing mortality and morbidity, Warwick says it highlights the need for research to stay up to date with the best therapeutic options available.

“The new surgical post will bring together clinical research and clinical care, with a focus on translating research outcomes into better and best care for children with burn injuries. This appointment will mean the Burns Unit is able to meet the rising demand, and maintain the standards of clinical excellence expected of a high volume service,” said Warwick.

“The person fortunate to take up this position will build on the firm foundation of evidence based care already in place in our Unit, and guarantee the RCH remains excellent and contemporary in both burns surgery and ongoing scar therapy,” said Warwick.

“The ability to protect time for burns research and think strategically will make sure we are constantly learning and evolving through research and innovation. In this way we can continue to provide the very best care for our patients.”

Advances in technology have also dramatically improved every aspect of burn care, from surgery, healing of wounds, right through to scar management. For the Burns Team, being able to utilise the latest technology means they can more effectively and efficiently treat children with burn injuries. With the addition of the fractional ablative CO2 laser, the Burns Unit will be better equipped to look after children through the full length of their burn care and recovery, including in long term scar management.

“The RCH has the very real opportunity to be a world leader in burns management. The comprehensive laser therapies and the breadth of services that we will now be able to deliver is unique,” said Warwick.

The new technology utilises laser energy to treat long term consequences of burn injury, including pigment changes and thick scars. By depositing heat deep into the skin, the treatment eliminates previously pigmented skin. The laser can also be used during different stages of wound care and recovery, particularly for children with deep scarring. The laser can cosmetically improve the appearance of scars, allow for greater range of movement and in turn improve quality of life. This will also mean children who may have previously had to undergo surgery could instead be treated with this far less invasive technology.

“Some children with serious or deep burns have contracture; the scar contracts as it heals and if this sits around a joint or around the face and neck it can be really difficult and restrict a child’s movement of joints. So, the ability to release the tension that is within them, that ability is crucial,” said Warwick.

“The laser can help with appearance and pigment changes but with this technology we can steer the scar in a better direction. There is also an opportunity to use the laser to help heal and treat scarring in some patients whereas you would normally have had to consider surgery which is more invasive, or steroid treatment, which may not be as effective in some cases.”

Nine year old Kieran is one of the hundreds of children who sustained a burn injury who could benefit from the new laser treatment. In 2017, Kieran suffered a burn to his abdomen when his pyjamas caught fire whilst helping his mum cook on a gas stove. Kieran underwent two surgeries for skin grafting, and continued burn wound therapy for many months with the surgical and allied health staff of the RCH Burns Team.

While in many respects, Kieran’s surgery and care has been very successful, his scar remains evident with pigment and skin thickening changes. Without the introduction of the laser technology, Kieran would have already reached the end of the road of what treatments were available to him, without consideration of further and unpalatable surgery. However, the innovation of laser therapies offers Kieran hope to continue his burn scar treatment, and to do so in a way that is minimally invasive and effective offering Kieran and many other children both hope and progress.

“Thanks to this generous funding, our team can grow and mature. We will now be resourced to be able to deliver on our vision, meeting both the enormous clinical demands of burn injury in children as well as realise our transformative research capabilities. This generosity has ensured the Burns Unit will be able to offer the most comprehensive multi laser service for children in Australia, providing Victorian children with complex burns scars with the best possible therapy options and the prospects of better outcomes,” said Warwick.