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IntroductionThe acute presentation of parastomal hernia (PSH) can range from exacerbation of pain to life-threatening incarceration. Managing the acute PSH is challenging, particularly in the presence of concomitant midline incisional hernia. Most literature focuses on the outcomes of elective PSH repair. There is a paucity of literature on optimal management approaches to emergency PSH presentations. We aim to evaluate the outcomes of management of acute PSH presentations at a large acute tertiary hospital over a 10-year-period.MethodsA retrospective analysis performed from May 2013 – May 2023 for all acute parastomal hernia presentations. The data collated included: demographics, index operation/pathology, duration of the stoma, clinical presentation, laboratory and imaging results and management outcomes (non-operative vs. operative intervention).ResultsTwenty-two admissions of acute PSH over the study period with the median age of 77 years, and 14 males. The median Charlson comorbidity score was 5. Most patients had stoma formation due to malignancy (12) with most end-colostomy (10). 11 patients had previous PSH repairs. 13 patients underwent operative intervention on index presentation via a combination of approaches. 4 required small bowel resection and 4 had resection of stoma; 4 had relocation of the stoma. There was one postoperative death due to sepsis related multi-organ failure. There were five recurrences of PSH on follow-up. Of the nine patients managed non-operatively, seven subsequently had elective reconstruction.ConclusionAcute PSH presentation usually requires operative intervention with considerable recurrence rates. The approach to the PSH repair, in the acute setting, needs to be individualised. Further study is required to assist with the development of guidelines for managing this difficult problem.

Introduction: Fireworks are commonly used to celebrate holidays and events with potential to impact livelihoods from blast injuries. This study aims to describe and analyse firework related burns in adults across Australia and New Zealand (ANZ). Methods: A retrospective review from January 2010 – January 2023 across all ANZ adult burns units. All firework related burn injuries in adults greater than 18 years that attended or were referred to the burns unit were included. Results: There were 173 patients with a firework related burn injury. The male to female ratio was 4.4:1 with the majority representing a younger age group (18–45 years). Men were significantly more likely to have firework related injuries at home and /or outside than women (49.3 % vs 24.2 %, p = 0.009). There were 29 firecrackers, 44 sparklers, and 99 firework burn injuries with significant differences in proportions between states for sparklers and fireworks. The mean TBSA was 4.3 % with significant differences amongst sex (men 4.7 % vs women 2.0 %, p = 0.042) and amongst states. Adequate first aid was reported higher in men than women (61.4 % vs 42.4 %, p = 0.047). Approximately half the injuries were hands and a third of injuries involved more than one body part. The most frequent type of injury was a full thickness burn (39.6 %), followed by mid dermal (24.1 %) and superficial (23.0 %) respectively. Conclusions: Firework related burns have distinct patterns of use and injuries amongst men and women with variations across states. Legislation and prevention are cornerstone to reducing the impact of burn related injuries.

Purpose Anastomotic leak (AL) is an uncommon but potentially devastating complication after rectal resection. We aim to provide an updated assessment of bowel function and quality of life after AL, as well as associated short- and long-term outcomes. Methods A retrospective audit of all rectal resections performed at a colorectal unit and associated private hospitals over the past 10 years was performed. Relevant demographic, operative, and histopathological data were collected. A prospective survey was performed regarding patients’ quality of life and fecal continence. These patients were matched with nonAL patients who completed the same survey. Results One hundred patients (out of 1,394 resections) were included. AL was contained in 66.0%, not contained in 10.0%, and only anastomotic stricture in 24.0%. Management was antibiotics only in 39.0%, percutaneous drainage in 9.0%, operative abdominal drainage in 19.0%, transrectal drainage in 6.0%, combination of percutaneous drainage and transrectal drainage in 2.0%, and combination abdominal/transrectal drainage in 1.0%. The 1-year stoma rate was 15.0%. Overall, mean Fecal Incontinence Severity Instrument scores were higher for AL patients than their matched counterparts (8.06±10.5 vs. 2.92±4.92, P=0.002). Patients with an AL had a mean EuroQol visual analogue scale (EQ-VAS) of 76.23±19.85; this was lower than the matched mean EQ-VAS for non-AL patients of 81.64±18.07, although not statistically significant (P=0.180). Conclusion The majority of AL patients in this study were managed with antibiotics only. AL was associated with higher fecal incontinence scores in the long-term; however, this did not equate to lower quality of life scores.

Introduction: The majority of burn injuries in the paediatric age group occur in the home environment and are preventable. Water pipe smoking, commonly known as shisha, is an old practice of tobacco smoking dating from the 16th century with the use of hot coals and water in social gatherings at homes or cafes. The increasing use of shisha worldwide in youth raises public health concerns regarding its detrimental health effects and potential for serious thermal injury. Our aim is to identify and classify epidemiological trends of shisha related burns in the paediatric age group across New South Wales and the Australian Capital Territory. Methods: A retrospective review from January 2009 – December 2019 at The Children’s Hospital at Westmead Burns Unit. All burn injuries of age less than 16 years that attended or were referred to the unit were included in this study. Results: There were 10 patients who presented with a shisha related burn injury. There was an equal distribution of males to females with all burns occurring in the home or a park. The most common types of injury were a full thickness or mid-dermal burns respectively, three of which required split thickness skin grafting. Conclusions: Shisha smoking is part of many cultures that has many potential burn hazards to children and family. Educational awareness targeted to shisha users can bring a better understanding about its potential for burn injury in children.

**Introduction**: With the increase of lithium battery devices, including electronic cigarettes and battery power banks, there has been a steady rise in burn injuries secondary to device malfunction. These devices may cause chemical or flame burns. Our aim was to identify and classify epidemiological trends of explosions from lithium battery devices across the state of New South Wales (NSW), Australia. **Methods**: A review of the NSW Burn Injury Service (SBIS) database from January 2005–December 2019, together with medical records from the burns units at the Children’s Hospital at Westmead (CHW), the Concord Repatriation General Hospital (CRGH) and the Royal North Shore Hospital (RNSH) was conducted. All patients who suffered a burn secondary from a lithium battery device were included and data was extracted on mechanism of injury, severity of injury and management. This study was approved by the ethics committees of CHW, RNSH and CRGH [2020/PID00179]. **Results**: Of the 24 patients identified, six were paediatric and 18 were adults. The majority were male (7:1) with a mean age of 29.0 (± 16.6 years). The mean total body surface area burnt was 2.5 per cent (± 0.9) [range 0.1–21.0%]. The majority occurred after 2014 and involved spontaneous explosions. Their injuries ranged from partial to full thickness burns with flame being the most common type (n=15). Three quarters of the cases (n=18) occurred in a home setting. **Conclusions**: Lithium battery device explosions can result in a mix of burn depth injuries from flame, contact and electrical, or chemical burns. Consumers need to be made more aware of the potential risks associated with use of lithium battery powered devices.

**Background**: Trauma remains a leading cause of morbidity and mortality in Australia. The objective of this South Australian study was to analyse epidemiological trends in facial fractures and assess the relationship between socioeconomic disadvantage and clinical outcomes. **Method**: A retrospective analysis of the relationship was conducted between socioeconomic disadvantage and facial fractures. All paediatric and adult patients with facial fractures who attended the Royal Adelaide Hospital and the Women’s and Children’s Hospital Adelaide between January 2012 and January 2017 either as in- or outpatients. The medical records, progress notes, imaging and operative notes from plastics, craniofacial and oral maxillofacial surgery teams were retrospectively collated into a registry and reviewed. Ethics approval was granted from the RAH Human Research and Ethics Committee [HREC/17/RAH/402]. **Results**: A total of 2559 patients, 1976 males (77.2%) and 583 females (22.8%), sustained a facial fracture. The most disadvantaged group had the highest proportion of facial fractures (36.9%), with the highest incidence in the 25–34 age group (22.4%). Assaults were the most common injury with decreasing odds as socioeconomic advantage increased (p

**Background**: Trauma remains a leading cause of morbidity and mortality in Australia. The objective of this South Australian study was to analyse epidemiological trends in facial fractures and assess the relationship between socioeconomic disadvantage and clinical outcomes. **Method**: A retrospective analysis of the relationship was conducted between socioeconomic disadvantage and facial fractures. All paediatric and adult patients with facial fractures who attended the Royal Adelaide Hospital and the Women’s and Children’s Hospital Adelaide between January 2012 and January 2017 either as in- or outpatients. The medical records, progress notes, imaging and operative notes from plastics, craniofacial and oral maxillofacial surgery teams were retrospectively collated into a registry and reviewed. Ethics approval was granted from the RAH Human Research and Ethics Committee [HREC/17/RAH/402]. **Results**: A total of 2559 patients, 1976 males (77.2%) and 583 females (22.8%), sustained a facial fracture. The most disadvantaged group had the highest proportion of facial fractures (36.9%), with the highest incidence in the 25–34 age group (22.4%). Assaults were the most common injury with decreasing odds as socioeconomic advantage increased (p