Paediatric hand and foot burns are common with secondary scar formation and contracture formation implicating growth and development. Negative Pressure Wound Therapy (NPWT) has been introduced in acute paediatric burn care to decrease the time to re-epithelialisation and therefore scar formation probability. However, there is a perception that NPWT may not be feasible in hand and foot burns resulting in these areas being omitted. The aim of this study was to assess if NPWT use on paediatric hand and foot burns is feasible. Method This single centre, two arm parallel-group, pilot randomised control trial was conducted at a quaternary paediatric burn’s unit in Queensland, Australia from April 2022 to June 2023. Hand and/or foot burns in children <16 years of age were randomised to one of two groups: Mepitel® (silicone) and Acticoat™ (silver nanocrystalline) or Mepitel®, Acticoat™ and NPWT (RENASYS Touch). The primary objective was trial feasibility defined as recruitment, treatment, data collection and study completion. The feasibility, complications and effectiveness of NPWT use on paediatric hand and foot burns was also assessed. Results Thirty-two participants were randomised. The screening percentage was 4.7%. This study met all trial feasibility parameters. There was no difference in clinician or familial perception of implementation feasibility between the two groups. 93.3% of participants stated they would use it again. Mepitel®, Acticoat™ and NPWT had significantly more issues with dressings lifting compared to Mepitel® and Acticoat™ (p=0.05, mean difference 26.7% 95% CI 2.5 – 50.9) however there was no difference in overall issues (p=0.1, mean difference 27.5% 95% CI -4.1 – 59.1). Conclusion This was a feasible trial with no difference in clinician or familial perception of NPWT implementation being demonstrated between the two groups. Concern regarding NPWT burden in paediatric hand and foot burns should therefore not be a barrier to implementation.