No parent wants to face the moment when a surgeon needs to cut burned tissue from their child’s body. But for many families, it’s a painful reality, particularly as children under five represent the highest hospitalisation rate for burns in Australia.
For clinicians, one of the biggest challenges is knowing how a child’s burn is likely to behave. The likelihood of infection. The extent of scarring, or the number of hospital visits needed for skin grafts and revision surgery. Then there’s other unknowns, such as the level of risk of long-term complications like chronic inflammation.
Dr Xanthe Venn, Senior Research Fellow at Future Industries Institute at the University of South Australia is probing such questions. Through her research with clinicians in Burns Units in both Western Australia and South Australia, Dr Venn is exploring ways to improve healing outcomes for burn patients. This work relates to stopping scar tissue forming and preventing the need for ongoing scar revisionary surgery, by understanding the balance between healthy immune response and harmful inflammation.
“We know around 220,000 Australians suffer a burn each year, and about 10% require hospitalisation,” she says. “Children under five have the highest rates of hospitalisation from burns.”
In the first days after a burn, the body launches its inflammatory response. “A little inflammation is a good thing. It’s a sign that the immune system doing its job,” Dr Venn explains. “But too much inflammation can lead to complications. It can contribute to damage to other organs and is linked to fibrosis, or excessive scarring.”
“If dead tissue remains on top of healthy tissue, it can trigger further damage – ‘die off’ and infection. So, it is important clinicians know which burns are so bad that a patient needs to go to surgery.”
Innovative ideas taking ‘Fliight’
Dr Venn is investigating the role of a protein called Flightless I (Flii), which affects how skin cells respond to damage and how scars form. Her work has shown that wounds tend to heal more effectively and with less scarring when Flii levels are lower.
“We think Flii is part of the reason some wounds don’t heal well. It interacts with key proteins in the body that regulate tissue repair and inflammation,” she says.
By identifying how Flii behaves in burn wounds, Dr Venn hopes to develop therapies that help clinicians predict healing outcomes and tailor treatments. These therapies could one day reduce the need for repeat surgeries, shortening hospital stays, and improving quality of life for burn patients.
This work was part of her broader research into skin biology, initiated at the Women’s and Children’s Health Research Institute before the lab’s relocation to the University of South Australia in 2013. Dr. Venn was awarded her PhD from the University of South Australia in 2016 for her investigation into the role of Flightless I in tissue regeneration.
Getting the balance right
Dr Venn is also looking more broadly at how to balance the body’s inflammatory response – not suppress it completely but modulate it – so wounds get the right ‘burst’ of immune activity to allow the wound to heal best. This could have major benefits, not just for burns, but also for people with chronic wounds caused by conditions like diabetes, where inflammation lingers for too long, and wounds fail to heal.
Ultimately, Dr Venn’s goal is to help support clinicians in their decisions about how best to treat each patient and to help prevent patients from needing to return to hospital.