SILKIE (Skin graftIng Low friKtIon Environment)
Research type
Research Study
Full title
Can skin grafting success rates in burn patients be improved by using a low friction environment – a feasibility study?
IRAS ID
178291
Contact name
Amber Young
Contact email
Sponsor organisation
University Hospitals Bristol NHS Foundation Trust
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
The research question is whether the introduction of a novel low friction environment will improve skin grafting success rates in patients with burns.
This study aims to find out if it is feasible to use low friction (slippery) sheets for burn patients requiring skin grafts.
Rationale: Skin grafts are required to ensure healing after burns that are deeper or take longer than 21 days to heal. Each year approximately 1000 skin grafts are undertaken in England and Wales; 75% in adults and 25% in children (1). 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 or stretching skin and moving new graft cells causing failure of attachment to the wound. Friction between dressings and bed sheets can cause this rubbing or stretching causing shearing. If dressings and patients were able to slide over the sheet when the patient moves in bed, then the graft may have more chance of ‘taking’. 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 services.
Population: Adult and paediatric patients who are selected to undergo skin grafting to achieve healing after burn injury as part of normal clinical care and are nursed on sheets for at least one overnight hospital stay.
Method: All patients in two burn centres (three hospital sites) will be cared for using low friction nursing as standard management. We will explore whether it is possible to use the sheets in burn wards, how acceptable the bedding is to patients and staff and whether patients are comfortable. During the 12 month study period, we will collect data on the success or failure (full or partial) of grafts. We will compare this with data obtained from the national burn injury database (iBID) during which normal friction sheets were in use. The costs of providing the sheets and of graft failure will also be collected.
Objectives: To explore the practical issues involved with the use of low friction sheets, to determine whether further research is required to show if this is a cost and clinically effective method of preventing skin graft loss and to explore the views of staff and patients who use them using semi-structured interviews and focus groups.
REC name
Wales REC 4
REC reference
15/WA/0156
Date of REC Opinion
25 Jun 2015
REC opinion
Further Information Favourable Opinion