Andrea Mc Kittrick (OT) ¹, Akane Katsu (OT)¹ , Dr Jeon Cha ²

1 Department of Occupational Therapy Royal North Shore Hospital, St Leonards, NSW, 2065, Australia

2 Department of Plastic and Reconstructive Surgery Royal North Shore Hospital, St Leonards, NSW, 2065, Australia

Background:

Deep dermal/ full thickness burns to the axilla are complex and challenging to manage. With the advancement of surgical techniques and technology over the last number of years management of these burns has evolved ¹ ².

Aim:

To complete a six year audit of surgical and occupational therapy interventions for full thickness/deep dermal burns sustained to the axilla to ensure best practice guidelines are adhered too. The aim of this audit is to determine if the rate of burn axilla reconstruction at RNSH is favourable in comparison to the published literature ³ ⁴ 5 6.

Results:

This audit will consist of a literature review to determine best practice in the published literature. File audits for all patients admitted to RNSH from 2010-2015 with full thickness/ deep dermal axilla burns to collect the surgical and occupational therapy interventions employed.  Analysis and comparison of the interventions provided at RNSH will occur.

Discussion:

A discussion of the results of interventions including the rate of axilla burn reconstruction at RNSH in comparison to published national and international guidelines will follow. Lastly recommendations for our practice and future research be included

References:

1. Farkhad, R. I., Ashraf, S. & Noreen, J. (2013). Post burn contracture treatment options and prevention. Pakistan Journal of Medical and Health Sciences, 7(2)
2. Anyan, I. W. R., Hopkins, R. L., Washburn, A., Lucio, J., Moriarty, J., Clark, J., Lundy, C., Perry, D., Faraklas, I. H. & Cochran, A. (2015). Serial casting of axillary burns: A pilot quality improvement study. Journal of Burn Care and Research, 36: S188
3. Jang, K. U., Choi, J. S., Mun, J. H., Jeon, J. H., Seo, C. H. & Kim, J. H. (2015). Multi-axis shoulder abduction splint in acute burn rehabilitation: A randomized controlled pilot trial. Clinical Rehabilitation, 29(5): 439-46 8p
4. Lester, M. E., Hazelton, J., Dewey, W. S., Casey, J. C. & Richard, R. (2013). Influence of upper extremity positioning on pain, paresthesia, and tolerance: Advancing current practice
5.  Grisbrook, T. L., Reid, S. L., Edgar, D. W., Wallman, K. E., Wood, F. M. & Elliott, C. M. (2012). Exercise training to improve health related quality of life in long term survivors of major burn injury: A matched controlled study. Burns, 38(8): 1165-73

Key Words

Full thickness/deep dermal burns, axilla burns, surgical and therapeutic management, audit