Update on the management of burns in paediatrics

Suman, A.; Owen, J.

doi:10.1016/j.bjae.2019.12.002

Cited by 28 publications

(43 citation statements)

References 18 publications

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“…However, high-quality pediatric burn care requires specialized equipment, monitoring, and personnel that the GBR is not currently capturing (e.g., availability of multiple sizes of supplies, pediatric-specific care knowledge and skills). According to the GBR, over half of the pediatric cohort sustained a burn that would warrant transfer to a burn center with a pediatric intensive care unit, specialized surgical care, and rehabilitation (at a minimum, a volume requirement of >100 children per year) ( 20 , 29 ). Over a third of facilities in the GBR treating pediatric patients (36%) would not qualify as a burn center according to these criteria.…”

Section: Discussionmentioning

confidence: 99%

Global trends in pediatric burn injuries and care capacity from the World Health Organization Global Burn Registry

et al. 2022

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BackgroundBurn injuries are a major cause of death and disability globally. The World Health Organization (WHO) launched the Global Burn Registry (GBR) to improve understanding of burn injuries worldwide, identify prevention targets, and benchmark acute care. We aimed to describe the epidemiology, risk factors, and outcomes of children with burns to demonstrate the GBR's utility and inform needs for pediatric burn prevention and treatment.MethodsWe performed descriptive analyses of children age ≤ 18 years in the WHO GBR. We also described facility-level capacity. Data were extracted in September of 2021.ResultsThere were 8,640 pediatric and adult entries from 20 countries. Of these, 3,649 (42%) were children (0–18 years old) from predominantly middle-income countries. The mean age was 5.3 years and 60% were boys. Children aged 1–5 years comprised 62% (n = 2,279) of the cohort and mainly presented with scald burns (80%), followed by flame burns (14%). Children >5 years (n = 1,219) more frequently sustained flame burns (52%) followed by scald burns (29%). More than half of pediatric patients (52%) sustained a major burn (≥15% total body surface area) and 48% received surgery for wound closure during the index hospitalization. Older children had more severe injuries and required more surgery. Despite the frequency of severe injuries, critical care capacity was reported as “limited” for 23% of pediatric patients.ConclusionsChildren represent a large proportion of people with burn injuries globally and often sustain major injuries that require critical and surgical intervention. However, critical care capacity is limited at contributing centers and should be a priority for healthcare system development to avert preventable death and disability. This analysis demonstrates that the GBR has the potential to highlight key epidemiological characteristics and hospital capacity for pediatric burn patients. To improve global burn care, addressing barriers to GBR participation in low- and low-middle-income countries would allow for greater representation from a diversity of countries, regions, and burn care facilities.

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Section: Discussionmentioning

confidence: 99%

Global trends in pediatric burn injuries and care capacity from the World Health Organization Global Burn Registry

et al. 2022

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“…The incidence of burns is higher in children than in adults. Almost 50% of patients are children; those under the age of 14 represent approximately one third of burn cases, 25% of them needing admission to hospital with severe lesions [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological and Clinical Profile of Pediatric Burns in the COVID-19 Era: The Experience of a Reference Center

et al. 2022

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Pediatric burns represent a significant public health problem. We analyzed the characteristics of pediatric burns in a reference center, in order to identify better strategies for prevention and care. Burn patients admitted to the pediatric departments of our hospital from January 2020 to June 2022 were retrospectively evaluated. Age, gender, the etiology of injuries, the total burn surface area (TBSA), the degree of burns, the length of hospital stay (LOS), concomitant SARS-CoV-2 infection, and burn surface microbial colonization were analyzed. Forty-seven patients were included in the analysis (M:F = 1:0.67). Most of the cases involved patients between 0 and 4 years of age (83%). Hot liquid burns accounted for 79% of cases, flame burns for 9%, thermal burns for 6%, scald burns for 4% and chemical burns for 2%. Mean TBSA was 14 ± 11%. A second-degree lesion was detected in 79% of patients and third-degree in 21%. Mean LOS was 17 days. No additional infection risks or major sequelae were reported in patients with SARS-CoV-2 infection. Fifteen different species of bacteria plus C. parapsilosis were isolated, while no anaerobic microorganisms were detected. In the light of our experience, we recommend a carefully planned and proactive management strategy, always multidisciplinary, to ensure the best care for the burned child.

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“…TBSA assessment of the burn was performed according to Wallace’s ‘Rule of Nines’, which divides the body surface into areas of 9% or multiples thereof. According to the literature [ 5 , 6 , 7 ], final assessment of burns should be recorded within the first 24 h following the accident in order to accurately define the extension of the lesion.…”

Section: Methodsmentioning

confidence: 99%

“…Almost 50% of burn injury patients in the world are children and 25% of them are admitted to hospital with severe burns [ 3 ]. Major and minor burn injuries in children require urgent medical evaluation and appropriate, dedicated treatment to avoid the recognised potential life-threatening complications, as well as aesthetic and functional sequelae [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Supporting the Regional Network for Children with Burn Injuries in a Pediatric Referral Hospital for COVID-19

Pelizzo

Vestri

et al. 2021

Healthcare

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Considerable reorganization of the regional network for pediatric burn treatment during the pandemic was required to cope with severe burn injuries in small children. In support of the emergency network for burns during the COVID-19 pandemic, we referred to regional indications for centralization in our hospital for all children aged less than 5 years who presented with severe burns, >15% of total body surface area (TBSA), or who necessitated admittance to the pediatric intensive care unit (PICU). A new service with a dedicated management protocol was set up to treat pediatric burns in our SARS-CoV-2 pediatric hospital during the lockdown period. A multidisciplinary burn treatment team was set up to offer compassionate and comprehensive burn care. Patient’s clinical data, burn features, treatment and follow up were recorded. A higher number of admissions was recorded from February to December 2020 compared with the same period in 2019 (52 vs. 32 admissions). Eighteen patients were admitted to the COVID-19 Service (10 M/8 F; 3.10 ± 2.6 yrs); ten children (55.5%) were hospitalized in the ward and eight in the ICU (44.5%). Fifty percent of the cases presented with lesions extending over >15% TBSA; in one case, TBSA was 35%. All patients suffered 2nd-degree burns; while five patients also had 3rd degree lesions covering more than 15% TBSA. All of the injuries occurred at home. No major secondary infections were recorded. Successful treatment was achieved in 94.4% of cases. The average length of stay was 15.2 ± 12.6 days. A proactive, carefully planned service, involving a multidisciplinary team, was created to ensure appropriate care in a pediatric hospital during the COVID-19 period, despite the effective pandemic associated challenges. Better health promotion in pediatric burn cases should also include dedicated TBSA assessment and a database of children’s burn characteristics.

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Update on the management of burns in paediatrics

Cited by 28 publications

References 18 publications

Global trends in pediatric burn injuries and care capacity from the World Health Organization Global Burn Registry

Global trends in pediatric burn injuries and care capacity from the World Health Organization Global Burn Registry

Epidemiological and Clinical Profile of Pediatric Burns in the COVID-19 Era: The Experience of a Reference Center

Supporting the Regional Network for Children with Burn Injuries in a Pediatric Referral Hospital for COVID-19

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