SILKIE

Can skin grafting success rates in burn patients be improved by using a low friction environment - a feasibility study?

Summary

This study aims to find out if it is feasible to use low friction (slippery) sheets for burn patients requiring skin grafts.

Skin grafts are required after some burns to ensure complete healing. Each year approximately 1000 skin grafts are undertaken; 75% in adults and 25% in children. Around 20% will fail completely or partially, with some wounds needing re-grafting. Further surgery, taking skin from another part of the body, longer hospital stays and increased scarring are all consequences which can be distressing for patients and expensive for the NHS. Graft loss can be caused by rubbing and moving new graft cells causing failure of attachment to the wound. Friction between dressings and bedsheets can cause this rubbing. If dressings could slide over the sheet when the patient turns, then the graft may have more chance of surviving. Reduced friction bed sheets are in use in the UK with premature babies and other patients to prevent pressure sores, but not yet in burns units.

Children and adults in two burns services will be recruited. We will explore whether it is possible and safe to use the sheets in burn wards, how acceptable the bedding is to patients and staff and whether patients are more or less comfortable. We will collect data on the success or failure (full or partial) of grafts for 12 months. The costs of providing the sheets and of graft failure will be collected, so that we can decide whether further research is required to show whether this is a cost effective method of preventing skin graft loss.

We have a Patient Advisory Group who will help at all stages of the study from designing patient information to advising on disseminating results. Findings will be published, sent to patient groups and used to design a larger trial.