Dr Guy Stanley1, Mr David Jacinto1, Dr Jodie Williams1

1Royal Darwin Hospital, 105 Rocklands Drive, Australia


Background: Accelerants ignite or enhance the development of fires but can rapidly cause severe burns. In the Northern Territory, planned fires are regulated, at a cost. Anecdotally, the NT burns service observed that accelerants contribute disproportionately to severe burns.

Methods: We conducted a 5-year, retrospective cohort study of accelerant burns admitted to Royal Darwin Hospital from 2014-2018 in a national and local context.

Results: In 38% of flame burns, an accelerant was used, which is significantly less than the national average. Predictive risk factors for a burn with an ignitable agent were male sex (8.75 risk ratio), living in the 0822 ‘remote rural’ postcode (1.48 risk ratio) and timing during the May-October Wet Season (1.22 risk ratio). Accelerant burns were associated with an absolute risk increase of mean Total Body Surface Area (9.12%), an increased mean length of stay (0.94 days) and a 15% increase in multiple body area burns, despite presenting on average 0.46 days earlier and receiving twice the rate of first aid, relative to non-accelerant burns. There was no year-on-year increase in accelerant burns.

Conclusion: The expense of a regulated fire and need to overcome waterlogged conditions in rural areas may explain why accelerant burns occur in particular post codes and times. We recommend simple education prior to the Wet Season, to reduce the overall risk to the public.

PGY4 General Surgical Service Registrar at Royal Darwin Hospital,

– Completed a ‘Masters of Surgery (Plastic/Reconstructive Surgery)’ from University Sydney

– Holds position of Pre-SET lead for Clinical Trials: Australia & New Zealand (CTANZ), Plastic & Reconstructive Surgery