Miss Yvonne Singer¹, Edward Raby², Alex Padiglione¹, Fiona Wood², Hana Menzes¹, Lincoln Tracy³, Belinda Gabbe^3,4, Heather Cleland¹

¹Victorian Adult Burns Service, The Alfred, Melbourne, Australia, ²State Adult Burn Service, Fiona Stanley Hospital, , , ³School of Public Health and Preventive Medicine, Monash University, , Australia, ⁴Heath Data Research UK Institute, Swansea University Medical School, Swansea University, Swansea, Wales

Abstract:

Burn wound colonisation can lead to wound infection, and occasionally sepsis. Wound swabbing is common to determine the presence of micro-organisms and wound infection. However, the burns community is yet to reach consensus on best practice swabbing procedures. This presentation will define the ‘wicked problem’ of burn wound swabbing in Australia and New Zealand through:

1. Analysis of the Burn Registry of Australia and New Zealand (BRANZ) methicillin-resistant Staphylococcus aureus (MRSA) wound swab data
2. Benchmarking Australian/New Zealand Burn Unit wound swabbing practices
3. Synthesis of the peer reviewed literature
4. Single site analysis of the number of wound swabs taken versus positive yield

Preliminary one-year analysis of BRANZ data shows low incidence of MRSA positive swabs (n=54, 1.6%), but variation across units in incidence. Previous bi-national benchmarking identified differences in triggers and techniques for wound swabbing across units, which likely influences the variance in the incidence of MRSA across units. Furthermore, the scientific evidence’s focus on severe injury does not reflect the contemporary Australian/New Zealand burn population.

“Wicked problems” are complex, have multiple contributing factors, and are hard to describe and resolve. This presentation will analyse 3 years of BRANZ MRSA wound swabbing data, re-benchmark swabbing practices, and synthesise existing evidence.  It is a call to action to our burn community to address this “wicked problem” by developing best practice wound swabbing guidelines to reduce unnecessary procedures and costs, standardise future BRANZ data and set the stage for the future BRANZ based Burn Quality Improvement Program.

Biography:

Bio to come