Oral Presentation ANZBA Annual Scientific Meeting 2025

A Pilot Randomised Control Trial of PICO™ (negative pressure wound therapy) Burden in Acute Paediatric Burns (22894)

Emma E Lumsden 1 2 , Roy R Kimble 1 2 , Robert R Ware 2 , Bronwyn B Griffin 2
  1. Paediatric Surgery , Queensland Children's Hospital, Brisbane, Queensland, Australia
  2. Faculty of Health, Griffith University, Gold Coast, Queensland, Australia

Introduction

Negative Pressure Wound Therapy (NPWT) has been introduced as an acute burn care adjunct to decrease time to re-epithelialisation and therefore scar formation; however, there is considerable burden associated with the larger NPWT devices – especially in the context of a paediatric patient. Substitution of the larger NPWT devices with a smaller device may minimise this burden whilst providing the benefits of NPWT. Therefore, this paper considers whether PICO™; a small, ultra-portable device, is a suitable alternative to the larger NPWT machines.

Methods

This was a pilot, single centre, three arm, parallel randomised control trial based at a quaternary paediatric burn’s hospital, Australia. Participants were randomised to one of: Mepitel® and Acticoat™ (Standard Dressings), Mepitel®, Acticoat™ and PICO™ or Mepitel®, ActicoatFlex™ and PICO™. The primary outcome of this trial was both the feasibility of the trial itself and the burden of PICO™ compared to standard dressings. The secondary outcomes were dressing complications, pain, itch, time to re-epithelialisation and scar formation at 3 months.

Results

31 participants were randomised to the trial from 5th of April 2023 to the 4th of October 2023. There was no difference in burden at the time of dressing application; however, over the duration of the study overall clinician perception of PICO™ burden increased. Dressing complications differed between the groups. PICO™ with Acticoat™ was found to have significantly more dressing complications when compared to standard dressings (p=<0.001). PICO™ and ActicoatFlex had no more dressing complications than standard dressings (p=0.1). Both PICO™ groups added significantly more workload to burns clinicians (p=0.01 Acticoat™ and p=0.04 ActicoatFlex) than standard dressings.

Conclusion

This trial identified that if PICO™ is used on an acute burn, it should be used in conjunction with ActicoatFlex™ not Acticoat™ as it had fewer associated dressing complications.