The Centre’s Recent Achievements
Continuing the ground-breaking work from the SiFTi study – SiFTi-II:
The aim of this study was to measure neutrophil function longitudinally following burn injury and to examine the relationship between neutrophil dysfunction and sepsis.
Sepsis is especially dangerous in patients with extreme burn injuries and can be hard to spot due to the inflammatory response occurring in burns patients. This cohort study tracked 150 patients with serious burns to more than 15% of their body over the period of a year.
Published in Annals of Surgery, this study found that neutrophil function, immature granulocytes count and plasma cell free DNA levels show potential as biomarkers for the prediction or early diagnosis of sepsis post-burn injury. Neutrophil dysfunction may also actively contribute to the development of sepsis. This means that targeting neutrophil dysfunction and IG release may be a viable therapeutic intervention to help reduce the incidence of nosocomial infections and sepsis post-burn.
SiFTi-II is a far bigger study, recruiting 245 patients and 30 healthy volunteers from burns centres across the UK. This new phase of the study will allow the sepsis blood test to be validated as well as being able to look at potential biomarkers over time to see if they are linked to scarring further down the line.
The Birmingham Objective Scar Scale study (BOSS):
As many treatments are becoming available that claim to treat or prevent bad scarring, it is ever more important to test them accurately with the right methods. The burns community has been traditionally using scar questionnaires for this purpose but this can be unreliable as the scores given can vary from person to person. More objective devices are available to measure scars but as they were originally developed for the cosmetic industry they are in need of testing on burn patients with scars. Therefore the BOSS study was formed to test these devices and also compare them to the scar questionnaires as well as scar biopsy samples. The team also collected information about quality of life.
The aims of the BOSS study were two-fold – 1. To see how reliable the readings from different scar measurement tools are when one, or more than one, clinician uses it. 2. To develop a score for the objective scar measurement tools.
The PEGASUS study:
Pressure garments are tightly fitting pieces of Lycra-based clothing which apply a constant pressure directly on the skin. They are used for patients who have had burn injuries and are worn day and night for about 12 months after the actual burn wound has healed. Wearing these garments may reduce the potential complications of scarring while providing comfort and helping to improve symptoms such as itch, which can be very distressing for patients recovering from burns.
Due to the small amount of evidence to confirm this as well as the lack of information about the costs of the garments and the staff time required to provide this treatment a feasibility study was given the go-ahead.
This study was an open pilot two-arm randomised controlled trial comparing Pressure Garment Therapy with no Pressure Garment Therapy for the prevention of normal scarring after burn injury. This project opened for recruitment in January 2015 and is funded by the Health Technology Assessment (HTA) Programme from the NIHR. The findings from this study are set to be published in the middle of 2018.
The announcement of a Scar Free Foundation Centre for Conflict Wound Research in Birmingham:
This centre is the result of £2.95m LIBOR funding with an additional £1.6m funding from University Hospitals Birmingham NHS Foundation Trust, University of Birmingham, University of the West of England and the JP Moulton Charitable Foundation. This centre is the UK’s first ever specialist medical research centre to focus on minimising the impact of scarring and improve the lives of armed forces personnel and civilians wounded in conflicts and terror attacks and will be based at the Queen Elizabeth Hospital in Birmingham.