Audit of thermally injured children under 5 years of age

Abstract

One-third of all admissions to the Wessex Regional Burns Unit (WRBU) are children under 5 years of age. These patients constitute a disproportionately large part of the workload in terms of nursing and medical care. A review of children admitted to the WRBU over a 5-year period was undertaken. Information was stored in a computer database (dBASE-IV) to simplify data analysis and to develop a system of data collection which can be used for audit. Eighty-one per cent of injuries were due to scalds. The mean burn surface area (BSA) was 8 per cent, and 78 per cent of injuries were smaller than 10 per cent BSA. Skin grafting was required in 44 per cent of patients. The mean time to operation was 13 days after injury. Significant hypertrophic scarring occurred in 60 per cent of patients and 12 per cent of patients were readmitted for further surgical procedures. There was one death. In an extension to the main database, associations between clinical and physiological observations and morbidity were sought. The data suggest that behavioural changes, 'shock', profound lymphocytopenia and pyrexia greater than 39.5 degrees C should be treated as strongly suggestive of the development of complications in the early stages after injury.