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Purpose: To review the Burns Service within Waikato Regional Burns Unit (WRBU) and specifically the use and infection rates of Biobrane (TM). Methods: Retrospective audit of hospital database and clinical records from January 2003 to July 2008. Data collection included age, sex, ethnicity, percentage burn, site and thickness of burn, time to transfer to regional burns centre, time to theatre for application of Biobrane, antibiotic or topical silver treatment, re-admission, total number of operations and overall cost of admission. Biobrane infection, causative organism and treatment. Results: WRBU admitted 830 patients (236 female and 594 male). A total of 124 patients (37 female and 87 male, average age 15.2 years) required application of Biobrane. Five patients were referred onto National Burns Centre. Mean length of stay 11.4 days (Median 6 days, range 1–68 days), percentage burn 15.6% (range 1–80%), transfer time 5 hours and time to theatre for application of Biobrane 13.5 hours (range 3.5 to >48 hours). Overall infection rate for Biobrane was 19.3% (23 from 119 patients). The main causative organisms were Staphylococcus aureus and Pseudomonas. Statistical analysis did not reveal a statistical significance (p = 0.05) in site, percentage or depth of burn, antibiotic cover or silver dressings and time to theatre for application. Re-admission was statistically significant for infected Biobrane patients (n = 6, p = 0.04). Conclusion: Biobrane infection rates of 19.3% in this audit are far higher than has been reported. This discrepancy may be due to the inclusion and exclusion criteria used in clinical trails. Biobrane remains a useful adjunct but the high risk of infection in our population may require stricter guidelines. [ABSTRACT FROM AUTHOR]