Innovation Partnerships Essential to Improve the Treatment of Children’s Burns in Rural and Remote Areas

Burns in children can be physically and psychologically traumatic – especially for those who can’t access ideal first aid and early wound care. In remote and rural areas, it is often not possible to access cool running water immediately – let alone fast access to a major hospital. This has major impacts on the healing and ongoing consequences of a burn. This challenge is the research focus of Associate Professor Bronwyn Griffin, who is dedicated to improving the acute treatment of paediatric burns, with a particular interest in supporting families in remote areas.

One of her main research goals, through her work at Griffith University Gold Coast, is to improve the delivery of burn injury first aid for children. This first aid care is critical, as it influences the likelihood of the child developing complications (such as severe scarring, skin grafting surgery, and psychological trauma) and impacts the child’s overall healing and recovery process.

Her work is highly regarded among local and international experts. A/P Griffin has a research grant from the US Department of Defense and is working with Californian emergency doctors, paramedics, and firefighters, Griffith University, and the Queensland Children’s Hospital. She is also leading a national project with children’s hospitals in Brisbane, Melbourne, Perth, and Sydney, trialling wound therapy in children with acute burn injuries.

A/P Griffin’s clinical experience as a paediatric emergency nurse is the driving foundation of her research. She has identified an exciting opportunity to combine her health expertise with innovation partners to address one of the biggest challenges with burns injury management – how to deliver care in remote locations.

A/P Griffin is enthusiastic about the potential partnerships made accessible through the Gold Coast Health and Knowledge Precinct’s community of HealthTech leaders and innovators. Innovation in this space has huge potential for the care of children in remote areas, as well as applications for global burn injury situations, such as bushfires, wildfires, and conflict zones.

Severe burns have serious complications and often happen in remote areas

A/P Griffin explained that two main factors influence the severity of a burn injury – the depth of the burn, and the size of the burn (how deep beneath the skin, and how big across the skin) and these have a large impact on the healing process.

“Sometimes you can have a very large-sized burn, but if it is superficial depth, it will heal fairly quickly. However, if you have a very deep injury, it may require a skin graft procedure,” said A/P Griffin.

Deeper and larger burns are unfortunately more common in regional or rural areas. Burn injuries in cities are often from spilled hot liquid like hot coffee, however, in rural areas, mechanisms of injuries can be more severe, for example through open fire or vehicle exhaust burns. These types of injuries tend to be a lot deeper and more challenging to treat.

Burns can have significant complications – even after a burn is healed, scarring of the skin in children has ongoing consequences as they grow

Quick and appropriate care of burn injuries anywhere is key to avoiding complications such as skin grafts, infection, joint issues, and severe scarring – but particularly so in rural areas. “One of the guiding principles is that we must get the burned skin to heal as quickly as possible, to avoid extensive scarring and or the need for a skin graft,” A/P Griffin said.

Best results for burn injury healing rely on receiving ideal first aid, including 20 minutes of cool running water, in the first 24-72 hours

A/P Griffin explained it is imperative to deliver as much care as possible from the time of injury across the 72 hours after the burn occurs. “Burn injuries are really dynamic – there are the initial insults to the skin, but then the heat is retained and the inflammation that remains can continue to progress the depth of the injury over the first 24-72 hours.”

“We do as much as possible in that short time while that wound is still in its dynamic phase, where we can directly impact the inflammation and decrease wound progression.”

However, the guideline of 20 minutes of cool, running water can pose challenges to children in families based outside of major cities, who are far from major hospitals, and without immediate, easy access to a constant flow of cool water.

A/P Griffin is determined to use HealthTech innovation to help her solve challenges with burn injury management in remote Australia and overseas

In major cities, most burn injuries occur in the home where there is access to running water. This is not the case in many rural areas. “For some farmers, the thought of running water for 20 minutes is anxiety-provoking. And in some places, they use artesian bore water, which can reach about 50 degrees Celsius, and will burn a child.”

“We’ve got to consider our rural and remote families and how to improve their early care when they’re so far away from a tertiary hospital, and when there are access issues to cool, running water within the first 24 hours of a burn injury.”

“Physical running water or negative pressure to a wound might be just a bit too complex to deliver in remote areas. But can we create something simple and achievable to be delivered in austere environments?”

Solving these challenges requires HealthTech and design expertise, combined with clinical and science experience

A/P Griffin is determined to use her research and clinical experience to help solve this issue and is working on an idea to create the effect of 20 minutes of cool running water in a burn situation in a remote area. She was inspired by a MedTech organisation that developed an IV-blood warmer for emergency transfusions – a portable fluid warmer that warms up blood to body temperature within seconds.

“I was thinking if there is tech capacity to do that with a heating device, then surely we can do something with cooling.”

To successfully launch this idea, a multidisciplinary team and industry collaborations will need to be involved.

“Partnership is key. I can have an idea, but I need people with the right technical/industrial/design skill set to help find a reliable, implementable solution.”

The Gold Coast Health & Knowledge Precinct and Lumina help foster multidisciplinary collaborations

A/P Griffin has established strong partnerships with clinicians, surgeons, nurses, as well as biostatisticians, and health economists. However, there is an opportunity for industrial design and entrepreneurial colleagues to support her idea and join her project team, which would greatly extend the capacity of her research.

“You need to have extremely motivated individuals to change practice.”

“We’ve got the clinical expertise and the science already, but we need to come together and be more dynamic – having medical innovators and design partners in the Precinct that could potentially jump on board and help us solve some of these really challenging problems would be amazing.”

Associate Professor Griffin is based with the School of Nursing and Midwifery at Griffith University and is a Member of the Steering Committee of the Burns Registry of Australia and New Zealand and the Injury Prevention Committee for Australia and New Zealand Burns Association. She is closely affiliated with leading Children’s hospitals in capital cities across Australia including the Queensland Children’s Hospital and the Centre for Children’s Health Research in Brisbane.