Understanding nutritional requirements of severe burn injury patients treated with a new skin substitute by directly measuring their individual energy expenditure.

We propose to undertake a 12-month intervetion study to measure energy requirements of severe burn injury patients who have undergone application of Novosorb® Biodegradable Temporising Matrix (BTM) as part of their surgical management. BTM is a relatively new dermal substitute now used at the Royal Adelaide Hospital (RAH) and other burns units nationally and internationally. The nutritional requirements for ensuring optimal integration of this product prior to surgical wound closure has not been studied previously, and current nutritional prescriptions are based on predictive equations developed from historic surgical and therapy techniques. Energy expenditure will be measured at pre-determined times (pre- and post-surgery and weekly until discharge) using indirect calorimetry, which represents the gold standard for assessment of energy expenditure. This will enable real-time adjustment of nutritional prescriptions to meet measured energy requirements determined via indirect calorimetry. As part of this study, we will also collect actual energy and protein intake data, to determine the adequacy of the nutrition prescription delivered. In order to ascertain how measured energy requirements compare to the conventional use of predictive equations in this population, a comparison of measured vs predicted requirements at each time point will be undertaken. This will assist with guiding future dietetic practice regarding the use of predictive equations or the need for ongoing use of indirect calorimetry for optimal clinical care in this patient population.