Demographics of Pediatric Burns in Vellore, India

Abstract

The American Burn Association, Children's Burn Foundation, and Christian Medical College in Vellore, India have partnered together to improve pediatric burn care in Southern India. We report the demographics and outcomes of burns in this center, and create a benchmark to measure the effect of the partnership. A comparison to the National Burn Repository is made to allow for generalization and assessment to other burn centers, and to control for known confounders such as burn size, age, and mechanism. Charts from the pediatric burn center in Vellore, India were retrospectively reviewed and compared with data in the American Burn Association National Burn Registry (NBR) for patients younger than 16 years. One hundred nineteen pediatric patients with burns were admitted from January 2004 through April 2007. Average age was 3.8 years; average total body surface area burn was 24%: 64% scald, 30% flame, 6% electric. Annual death rate was 10%, with average fatal total body surface area burn was 40%. Average lengths of stay for survivors was 15 days. Delay of presentation was common (45% of all patients). Thirty-five of 119 patients received operations (29%). Flame burn patients were older (6.1 years vs 2.6 years), larger (30 vs 21%), had a higher fatality rate (19.4 vs 7.7%), and more of them were female (55 vs 47%) compared with scald burn patients. Electric burn patients were oldest (8.3 years) and all male. When compared with data in the NBR, average burn size was larger in Vellore (24 vs 9%). The mortality rate was higher in Vellore (10.1 vs 0.5%). The average mortal burn size in Vellore was smaller (40 vs 51%). Electric burns were more common in Vellore (6.0 vs 1.6%). Contact burns were almost nonexistent in Vellore (0.9 vs 13.1%). The differences in pediatric burn care from developing health care systems to burn centers in the US are manifold. Nonpresentation of smaller cases, and incomplete data in the NBR explain many of the differences. However, burns at this center in Vellore, India were larger, and occurred to younger patients than burns that reported in the NBR. Individualized assessment of care systems are needed when implementing development plans.

Hot milk burns in children: a crucial issue among 764 scaldings

“…In the series considering scaldings that are sub-titled, some differences evolve in the clinical course and outcomes of the patients; however, previous reports regarding such subgroups of scalding and the number of the patients studied are limited. [3] In our study, according to our literature search, we present the largest series on scalding comparing hot water and other concentrated liquids. To evaluate the outcomes of different concentrated liquid burns in children, we prospectively followed up the burned pediatric patients.…”

“…Milk burns have significantly higher mortality risk than other scalds. [3] In conclusion, scalding is the most frequent burn cause among the Turkish pediatric population. Hot milk burns should be considered as an important entity among scalds as they have a complicated clinical course and considerable mortality rates.…”

Retrospective analysis of burn injuries caused by hot milk in 159 pediatric patients: 14 years of experience in a burn unit

“…To be less able to perceive danger, have less control over their environment and to react slower in situations that can lead to injury, occasionally make the injury unavoidable in small children. [16] As shown in our study, childhood scalding injury is frequently observed among the preschool period, especially between the ages of 2 and 3 years [1][2][3][5][6][7][17][18][19] in which the abilities that increased tendency to injuries were gained such as independent mobility, exploratory behavior, and hand-to-mouth activity. [20,21] Similar to the previous studies from Turkey [23,25] the mechanism of hot milk burns was most commonly the immersion and most frequently affected anatomical parts were the lower extremities and the trunk.…”

“…It requires a treatment process including a multidisciplinary approach by experienced burn surgeons and health care professionals in a well-equipped burn unit or center. Majority of burns among the pediatric patients was caused by scalding in both developed [1,2] and developing countries, [3,4] as well as in Turkey. [5][6][7] Particularly, this trauma is frequently observed among the children that belonged to joints.…”

“…[1][2][3][4][5][6][7] The region that our burn unit provided health care has some traditional sources of burn trauma including homemade tomato paste, jam, boiled grape juice, and dairy products such as cheese and yogurt. [5,8] Burns due to hot milk should be considered as separately because of its physical and chemical properties.…”