Infection is the primary cause of complications following a burn injury. Even a small hot water scald can become infected, which can lead to a great increase in pain, delayed healing, increased scarring, and a greater time in treatment (including antibiotic usage and surgery). This not only undermines the outcome for patients, but also increases costs to the NHS related to treatment and for patients, in terms of days off work, travel to hospital, and related loss of income. In rare cases infection can lead to death, particularly in large and deep burns and even in children with small burns, via complications such as toxic shock syndrome.
Despite the importance of identifying infection, this currently remains a major challenge for clinicians. Much of the difficulty arises from the fact that the symptoms of infection in burn patients can be very difficult to distinguish from other symptoms arising from inflammatory response to the burn itself, as well as other illness such as cold, sore throat etc. Because of these challenges, the standard methods that clinicians use to diagnose infection under other conditions are of limited value in treating burns patients. The situation is further complicated by the fact that most wounds have normal background level of bacteria, which does not need to be treated unless bacteria reach a certain level at which they begin to cause harm. However, clinicians may wait around three days to confirm the presence of bacteria in a wound, but these tests do not distinguish between beginning background levels and those representative of infection.
Collectively, these limitations can also lead to patients being 'over treated', resulting in over and unnecessary prescription of antibiotics, dressing changes (which are often painful and may increase the risk of scarring), and extended hospital stay.
This work has been funded by the Medical Research Council through the Biomedical Catalyst stream, and is led by the University of Bath, with University of Brighton researchers as co-investigators.
Example of prototype infection-detecting dressing. Clinically relevant infection is clearly signalled by development of a bright green colour within the dressing
Watch the film about this research (produced by Bath University)