Fiona M Wood

Fiona M Wood
University of Western Australia | UWA · Burn Injury Research Unit (BIRU)

MBBS BSc FRCS FRACS

About

409
Publications
74,071
Reads
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8,700
Citations
Citations since 2017
113 Research Items
5056 Citations
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201720182019202020212022202302004006008001,000
Additional affiliations
January 1991 - present
Royal Perth Hospital
Position
  • Director of the Burn Service of WA

Publications

Publications (409)
Conference Paper
Introduction Hot tap water scalds (TWS) can have devastating consequences and lifelong impact on survivors. Collaborating with bi-national, plumbing regulatory stakeholder organisations we undertook a study to (i) describe the frequency, demographic profile and in-hospital outcomes of people with TWS admitted to Australian and New Zealand burn cent...
Article
Introduction Scalds from hot tap water can have devastating consequences and lifelong impact on survivors. The aims of this study were to (i) describe the frequency, demographic profile, injury event characteristics, and in-hospital outcomes for people with tap water scalds admitted to Australian and New Zealand burn centres; and (ii) determine whe...
Article
Full-text available
There is an urgent need for interventions that improve healing time, prevent amputations and recurrent ulceration in patients with diabetes-related foot wounds. In this randomised, open-label trial, participants were randomised to receive an application of non-cultured autologous skin cells (“spray-on” skin; ReCell) or standard care interventions f...
Article
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Keloid scarring is a fibroproliferative disorder of the skin with unknown pathophysiology, characterised by fibrotic tissue that extends beyond the boundaries of the original wound. Therapeutic options are few and commonly ineffective, with keloids very commonly recurring even after surgery and adjunct treatments. Epigenetics, defined as alteration...
Article
Introduction Posttraumatic growth (PTG) is “the subjective experience of positive psychological change reported by an individual as a result of the struggle with trauma” (Zoellner and Maercker, 2006 [1]). PTG after burn is similar to PTG after other types of trauma (Martin et al., 2016 [2]). The aim was to assess the relationship between coping sty...
Article
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Hippocrates apparently claimed that all disease begins in the gut. However, as Sudeep et!al. highlight [1], nearly 2500! years later, the complex interactions between the immunometabolic effects of the gastrointestinal microbiota and the pathophysiological manifestations of sepsis remain only partially understood. Critical illness is associated wit...
Article
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Keloid scars are difficult to manage and remain a therapeutic challenge. Corticosteroid therapy alone or ionising radiation (radiotherapy) alone or combined with surgery are first-line treatments, but the scientific justification for these treatments is unclear. The aim of this systematic review and meta-analysis of randomised controlled trials (RC...
Article
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Smartphones are now integral to many telehealth services that provide remote patients with an improved diagnostic standard of care. The ongoing management of burn wounds and scars is one area in which telehealth has been adopted, using video and photography to assess the repair process over time. However, a current limitation is the inability to ev...
Preprint
Full-text available
Scarring is a lifelong consequence of skin injury, with scar stiffness and poor appearance presenting physical and psychological barriers to a return to normal life. Lysyl oxidases are a family of enzymes that play a critical role in scar formation and maintenance. Lysyl oxidases stabilize the main component of scar tissue, collagen, and drive scar...
Article
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Background: Patients with burn injuries are considered to have an increased risk of venous thromboembolism (VTE). While untreated VTEs can be fatal, no studies have examined chemoprophylaxis effectiveness. This study aimed to quantify the variation in prevalence of VTE prophylaxis use in patients in Australian and New Zealand burns units and wheth...
Article
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PurposeIn adults requiring treatment in an intensive care unit, probiotic therapy using Lactobacillus plantarum 299v may reduce nosocomial infection. The aim of this study was to determine whether early and sustained L. plantarum 299v therapy administered to adult ICU patients increased days alive and at home.MethodsA multicentre, parallel group, p...
Article
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Introduction: Caesarean delivery is steadily becoming one of the more common surgical procedures in Australia with over 100 000 caesarean sections performed each year. Over the last 10 years in Australia, the caesarean section rate has increased from 28% in 2003 to 33% in 2013. On the international stage, the Australian caesarean delivery rates ar...
Article
Introduction: The ageing global population presents a novel set of challenges for trauma systems. Less research has focused on the older adult population with burns and how they differ compared to younger patients. This study aimed to describe, and compare with younger peers, the number, causes and surgical management of older adults with burn inj...
Article
Background In 2009, the Burns Registry of Australia and New Zealand (BRANZ) published a set of clinical quality indicators (QIs) to monitor performance, improve quality of care, and inform and change policy. With several years of data collected since the initial development of the indicators for burns, the BRANZ QI Working Party reviewed the clinic...
Article
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Epidemiological studies have demonstrated that survivors of acute burn trauma are at long-term increased risk of developing a range of morbidities. The mechanisms underlying this increased risk remain unknown. This study aimed to determine whether burn injury leads to sustained immune dysfunction that may underpin long-term morbidity. Plasma and pe...
Article
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Interactions between keratinocytes and fibroblasts in the skin layers are crucial in normal tissue development, wound healing, and scarring. This study has investigated the role of keloid keratinocytes in regulating collagen production by primary fibroblasts in vitro. Keloid cells were obtained from removed patients’ tissue whereas normal skin cell...
Article
Pulmonary fibrosis is characterised by excessive scarring in the lung which leads to compromised lung function, serious breathing problems and in some diseases, death. It includes several lung disorders with idiopathic pulmonary fibrosis (IPF) the most common and most severe. Pulmonary fibrosis is considered to be perpetuated by aberrant wound heal...
Article
Introduction Compression, a common treatment of choice for the management of edema, is one intervention which is applied with little objective understanding of the optimal parameters of application or efficacy in acute burn wounds. Aim The aim of this study was to determine the effectiveness of different methods of compression for the management o...
Article
Full-text available
As a part of an abnormal healing process of dermal injuries and irritation, keloid scars arise on the skin as benign fibroproliferative tumors. Although the etiology of keloid scarring remains unsettled, recent considerable evidence suggested that keloidogenesis may be driven by epigenetic changes, particularly, DNA methylation. Therefore, genome-w...
Article
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Epigenetic regulatory mechanisms are essential for maintaining skin homeostasis and aid in the processes of wound healing. The nucleus co‐ordinates gene expression using epigenetic regulatory mechanisms based on distinct chromatin structural states and their remodelling. These include DNA methylation and hydroxymethylation, post‐translational histo...
Article
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Introduction The effect of early and sustained administration of daily probiotic therapy on patients admitted to the intensive care unit (ICU) remains uncertain. Methods and analysis The Restoration Of gut microflora in Critical Illness Trial (ROCIT) study is a multicentre, randomised, placebo-controlled, parallel-group, two-sided superiority tria...
Article
Background Priority setting and resource allocation in health care, surveillance and interventions is based increasingly on burden of disease. Several methods exist to calculate the non-fatal burden of disease of burns expressed in years lived with disability (YLDs). The aim of this study was to assess the burden of disease due to burns in Western...
Article
Background: Bioimpedance spectroscopy (BIS) is a tool that can be used to measure body composition in a variety of populations. Previous studies have investigated novel applications to utilize BIS to measure localized body composition, including in the hand. According to BIS guidelines, there should be no skin wounds at the site of electrodes, and...
Article
Introduction The assessment of swelling following burn injury is complicated by the presence of wounds and dressings, and due to patients experiencing significant pain and impaired movement. There remains a lack of sensitive objective measures for edema in patients presenting with hand burn injury. Bioimpedance spectroscopy (BIS) is a measure of bo...
Article
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Fungal kerion is a hypersensitivity reaction to a scalp dermatophyte which gains access to the hair shaft following physical trauma. However, precipitating injuries are rarely reported. We report the case of a 4-year-old girl who presented with non-healing scalp lesions following a deep dermal forehead scald caused by hot water. The third degree bu...
Article
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The aim of this research was to investigate the use of shear wave elastography as a novel tool to quantify and visualize scar stiffness after a burn. Increased scar stiffness is indicative of pathologic scarring which is associated with persistent pain, chronic itch and restricted range of movement. Fifty-five participants with a total of 96 scars...
Article
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Shear-wave elastography (SWE) is an ultrasound based technology that can provide reliable measurements (velocity) of scar stiffness. The aim of this research was to evaluate the concurrent validity of using both the measured velocity and the calculated difference in velocity between scars and matched controls, in addition to evaluating potential pa...
Article
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The timely resolution of wound healing is critical for restoring the skin as a protective barrier. The switch from a proinflammatory to a reparative microenvironment must be tightly regulated. Interleukin (IL)-6 is a key modulator of the inflammatory and reparative process: it is involved in the differentiation, activation, and proliferation of leu...
Article
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Background The effect of early and sustained administration of daily probiotic therapy on patients admitted to the intensive care unit remains uncertain. Objective To describe the study protocol and statistical analysis plan for the restoration of gut microflora in critical illness trial (ROCIT). Design, setting and participants ROCIT is multicen...
Article
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Hot water immersion (HWI) therapy is an effective and validated treatment for a variety of marine stings. Unsupervised, however, it poses a significant risk of thermal injury. Herein, we describe our experience of iatrogenic thermal injury secondary to marine sting treatment. A five-year retrospective review of all iatrogenic thermal burns secondar...
Article
Introduction The assessment of swelling following burn injury is complicated by the presence of wounds and dressings, particularly as the patient cohort experience significant pain, impaired movement, and may require medications that result in modified behavior. Further, traditional measures of volume, such as water displacement volumetry (WDV) or...
Article
Introduction A lower limb burn arguably has a significantly greater effect than an upper limb burn due to the detrimental impact on ambulation and return to daily roles and function. The patterns of functional recovery following a lower limb burn are poorly understood and has only been studied in small cohorts. It was hypothesized that patients, fo...
Article
Introduction Compression, a common treatment of choice for the management of edema, is one intervention which is applied with little objective understanding of the optimal parameters of application or efficacy in a patient with an acute burn wound. The aim of this study was to determine the effectiveness of different methods of compression for the...
Article
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Background: Burden of disease estimates are an important resource in public health. Currently, robust estimates are not available for the burn population. Our objectives are to adapt a refined methodology (INTEGRIS method) to burns and to apply this new INTEGRIS-burns method to estimate, and compare, the burden of disease of burn injuries in Austr...
Article
Background: Due to the increased mortality and morbidity associated with blood transfusion, identifying modifiable predictors of transfusion are vital to prevent or minimise blood use. We hypothesised that burn patients with diabetes mellitus were more likely to be prescribed a transfusion. These patients tend to have increased age, number of como...
Article
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Abstract While treatment for burn injury has improved significantly over the past few decades, reducing mortality and improving patient outcomes, recent evidence has revealed that burn injury is associated with a number of secondary pathologies, many of which arise long after the initial injury has healed. Population studies have linked burn injury...
Article
Background: The objective of this study was to describe and quantify the long-term hospital service use (HSU) after burn injury and associated costs in a population-based cohort of patients with unintentional burns and compare with uninjured people. Methods: This retrospective population-based cohort study analysed de-identified linked health ad...
Article
Scar formation after wound healing is a major medical problem. A better understanding of the dynamic nuclear architecture of the genome during wound healing could provide insights into the underlying pathophysiology and enable novel therapeutic strategies. Here, we demonstrate that TGF‐β‐ induced fibrotic stress increases formation of the dynamic s...
Article
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Background: One Australian loses a limb every 3 h as a result of infected diabetic foot ulcers (DFU). This common condition accounts for substantial morbidity and mortality for affected individuals and heavy economic costs for the health sector and the community. There is an urgent need to test interventions that improve wound healing time, preven...
Article
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Objectives Hot environmental conditions can result in a high core-temperature and dehydration which can impair physical and cognitive performance. This study aimed to assess the effects of a hot operating theatre on various performance, physiological and psychological parameters in staff during a simulated burn surgery. Methods Due to varying acti...
Article
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Background Recent population studies have shown an increase in cancer rates in patients after burn injury over a 30-year follow-up period. This work aims to understand the mediators and mechanisms that lead to cancer susceptibility after acute burn. Methods In silico analytics with Watson for Drug Discovery were performed to interrogate networks a...
Article
Background: Knowledge of the epidemiology of burn-related fatalities is limited, with most previous studies based on hospital and burn centre data only. Aims: To describe the epidemiological characteristics of all burn-related fatalities in Australia and New Zealand, and to identify any trends in burn-related fatality incidence over the study pe...
Article
Review question/objective: The question of this review is: What is the effectiveness and safety of perioperative enteral nutrition in patients with burn injuries?More specifically, this systematic review will aim to determine whether short fasting (nasogastric feeding up to two hours prior to theater and immediately thereafter) or nil fasting (nas...
Article
Objective: Burns cause acute damage to the peripheral nervous system with published reports identifying that neurological changes after injury remain for a prolonged period. To shed some light on potential mechanisms, we assessed injury etiology and patterns of nervous system morbidity after injury by comparing long-term hospital admissions data o...
Article
Introduction Time to healing is a key driver of scar outcome in the repair of skin post burn injury. Autologous skin cell suspension has facilitated early intervention or wound healing in isolation in partial thickness injuries and in combination with traditional techniques in deeper injuries with limited donor sites. The aim of the presentation is...
Article
Introduction Recent epidemiological studies have linked burn injury to long-term increased risk of cancer. The increased risk appears greater in female patients, however, our current understanding of the link between burn injury and lifetime cancer risk remains limited. Here, we have investigated possible links between burn injury and cancer using...
Article
Introduction Burns are a significant cause of morbidity and mortality worldwide, and while the acute impact of burns on immune function has been well characterised, the long-term impacts are only more recently coming to light. Epidemiological evidence of long-term effects of burn injury include increased mortality risk, increased susceptibility to...
Article
Objective: The study aimed to investigate short-interval intracortical inhibition (SICI) in burns survivors and non-injured controls, and establish whether paired-pulse transcranial magnetic stimulation (TMS) is a sensitive tool to investigate SICI after burn-injury. Methods: Burn survivors underwent experimental assessments at 6- and 12-weeks a...
Article
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Background Major burns are life threatening. Fluid resuscitation is required for survival to maintain intravascular volumes and prevent hypovolemic shock. Bioimpedance spectroscopy (BIS) has been recognised as a potential method of monitoring fluid shifts after burn and in other disease states. The aims of this study were to examine the reliability...
Article
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Background: Injury triggers a range of systemic effects including inflammation and immune responses. This study aimed to compare infectious disease admissions after burn and other types of injury using linked hospital admissions data. Methods: A retrospective longitudinal study using linked health data of all patients admitted with burns in West...
Article
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Background A number of studies report high prevalence of mental health conditions among burn patients. However there is a need to understand differences in the temporal relationship between mental health conditions and intentional and unintentional burns to hasten psychological prevention and intervention. This study aims to compare the socio-demog...
Article
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Background Burns are a devastating injury that can cause physical and psychological issues. Limited data exist on long-term mental health (MH) after unintentional burns sustained during childhood. This study assessed long-term MH admissions after paediatric burns. Methods This retrospective cohort study included all children (< 18 years) hospitali...
Article
After similar extent of injury there is considerable variability in scarring between individuals, in part due to genetic factors. This study aimed to identify genetic variants associated with scar height and pliability after burn injury. An exome-wide array association study and gene pathway analysis were performed on a prospective cohort of 665 pa...
Poster
Research Objective: A severe burn accident (e.g. from chemicals or flame) is a life-changing event to many patients and their families. Physiologically, it is a burden to their body because our skin is the part of our immune system that protects us from our environment; losing the epidermis and dermis means that the barrier to bacteria and other pa...
Poster
Introduction: In planning surgical intervention to treat burn injuries, consideration needs to be given to the extent and depth of the wound and the potential donor sites for skin harvesting, as well as skin substitutes currently available. Looking forward, the concept of skin regeneration using 3D bioprinters to produce cell-scaffolds composite ti...
Article
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Miniaturised optical coherence tomography (OCT) fibre-optic probes have enabled high-resolution cross-sectional imaging deep within the body. However, existing OCT fibre-optic probe fabrication methods cannot generate miniaturised freeform optics, which limits our ability to fabricate probes with both complex optical function and dimensions compara...
Article
Ephrin ligand/Eph receptor signaling is important in both tissue development and homeostasis. There is increasing evidence that Ephrin/Eph signaling is important in the skin, involved in hair follicle cycling, epidermal differentiation, cutaneous innervation and skin cancer. However, there is currently limited information on the role of Ephrin/Eph...
Article
Background: Burn injuries to workers can have a devastating impact, however knowledge of the epidemiology of work-related burn injuries in Australia and New Zealand is limited. Purpose: To describe epidemiological characteristics of work-related burn injuries in Australia and New Zealand, and to compare these with non-work-related burns. Method...
Article
Burn scars can be associated with significant loss of cutaneous sensation, paresthesia and chronic pain. Long-term systemic changes in cutaneous innervation may contribute to these symptoms and dorsal root ganglia have been implicated in the development of chronic neuropathic pain. Therefore we hypothesized that changes in cutaneous innervation aft...