Burn Injuries In Children Research Articles

Применение интраназального препарата интерферона альфа-2b в комплексном лечении детей с ожоговой травмой

Objective. To assess the effect of intranasal recombinant interferon alpha-2b medicine (IFN-α2b, Grippferon) in the complex treatment of children with thermal burn injury based on the changes in the clinical parameters and the levels of pro- and antiinflammatory cytokines in saliva. Patients and methods. The study included two groups of children with thermal burn injury that were comparable by gender, age and burn injury type. Main group patients (Group I, n = 20) received recombinant human IFN-α2b medicine intranasally in addition to the basic treatment, whereas the control group patients (Group II, n = 20) were given only the basic therapy. The results were compared with data of 20 healthy children (healthy controls). The levels of IFN-α2, IFN-γ, IL-1a, -1b, -4, -5, -6, -10, TNF-α and TNF-β were measured during follow-up visits on days 1 and 10 in the hospital. Results were analysed using Statistica 6.0 software. Null hypotheses were rejected at p < 0.05. Results. Our findings reveal that the levels of pro- and anti-inflammatory cytokines in all patients were lower, than those in healthy controls (p < 0.050), except for IL-6 and IL-10, whose levels increased (p = 0.001 and p = 0.012, respectively). The levels of mediators correlated with the burn area and depth (0.031 ≤ p ≤ 0.050). The use of intranasal recombinant IFN-α2b medicine was associated with a less pronounced imbalance in the levels of pro- and anti-inflammatory cytokines and ensured a 20% reduction in the absolute risk of acute respiratory viral disease (χ2 = 4,44, p = 0,035). Conclusion. Thermal burn injury in children can compromise the immunological homeostasis, manifested by changes in the levels of pro- and anti-inflammatory cytokines in mixed unstimulated saliva. Intranasal recombinant IFN-α2b medicine (Grippferon) has an immunomodulatory effect and can be recommended as a part of complex treatment of children with thermal burn injury for the prevention of acute respiratory viral diseases. Keywords: burn, thermal burn injury, cytokines, interferon alpha-2b, Grippferon, prevention, acute respiratory viral infections

Plasma lipidomics reveal systemic changes persistent throughout early life following a childhood burn injury

Abstract Background Non-severe paediatric burns can result in poor long-term health outcomes. This occurs even in cases with good acute burn-related outcomes, including minimal scarring. The mechanisms that underpin the transition from non-severe burn to sustained negative long-term health impacts are currently unknown. However, sustained metabolic and immune changes have been observed in paediatric burn studies, suggesting these changes may be important. The plasma lipidome consists of a rich pool of bioactive metabolites that play critical roles in systemic processes including molecular signalling and inflammation. We hypothesised that changes in the plasma lipidome may reflect underlying changes in health status and be linked to long-term health after burn trauma. Methods This study analysed the lipidome in children who had previously experienced a non-severe burn, compared to non-injured controls. Thirty-three participants were recruited between the ages of 5 and 8 years who had experienced a non-severe burn between the ages of 1 and 3 years. Plasma samples were also collected from a non-injured, healthy, age and gender matched control group (n = 21). Plasma lipids were measured using reversed-phase liquid chromatographymass spectrometery (LC-MS). Results In total 838 reproducible lipid species from 19 sub-classes passed quality control procedures and progressed to statistical analysis. Analysis of individual lipid metabolites showed significantly higher concentrations of lysophosphatidylethanolamines and phosphatidylethanolamines, and significantly lower concentrations in myristic, palmitic and palmitoleic acids in the plasma of those who had experienced burn injury compared to controls. Conclusion Long-term changes in the lipid profile may give insight into the mechanisms underlying poor long-term health subsequent to non-severe burn injury. Further work to investigate the relationship between long-term pathology and lipidomic changes may lead to a better understanding of the causes of secondary morbidity post-burn and to clinical intervention to reduce the long-term health burden of burn trauma.

Psychosocial Impact of Electrical Burn in Children: A Follow-Up Study Conducted at a Tertiary Care Hospital.

Introduction Electrical burn injuries are very common in the pediatric population and are usually accidental and sometimes occupational. The objective of our study was to evaluate the epidemiology of electrical burn injuries and prospectively evaluate the long-term psychosocial impact of electrical burn injuries in children. Materials and methods A qualitative interview study was conducted prospectively among sixty patients presented to Holy Family Hospital, Rawalpindi, Pakistan. Demographic details, mode of presentation, detail of injury, total body surface area, initial condition, and surgical interventions were noted during their stay at the hospital. Their physical and psychological outcomes were evaluated by administering the Strength and Difficulties Questionnaire (SDQ) and Body Dysmorphic Disorder Questionnaire (BDDQ) via telephonic interviews after six weeks of discharge from the hospital. The study was conducted over a span of 1 year from January 2021 to January 2022. Results There were 60 patients who presented to the department of pediatric surgery during the span of the study. The mean age was 9.9 years ± 3.133 years (SD) and 80% of the patients were above 8 years of age with a male-to-female percentage of 86.67% to 13.33%, respectively. Forty-two (70%) patients incurred high-voltage electrical burns while 18 (30%) suffered low-voltage electrical burns. Mortality was 13.33% (n=8). Out of 52 patients who survived, 35 (67.30%) were labeled as having Body Dysmorphic Disorder upon administration of BDDQ through a six-week follow-up. The majority of the patients had abnormal or borderline results in different scales of SDQ. Conclusion The long-term psychological stress and the varied spectrum of psychiatric disorders in electrical burn patients are profound. The prevention of burn injuries can be effectively achieved by educating parents about safety measures and improving health infrastructure. Implementation of a dedicated national program for psychological support of burn patients should be made accessible to all patients.

Prevalence and risk factors of cooking-related burn injury among under-five-years old children in a resource-limited setting: a community-based cross-sectional study in Northwest Ethiopia

Cooking-related child burn injury causes a greater health burden in low-and-middle-income countries. Therefore, a community-based cross-sectional study was conducted among 5830 under-five-years old children in a resource-limited community in Northwest Ethiopia to determine the prevalence and risk factors of this child health problem. Data were collected by trained nurses using a questionnaire and the logistic regression analysis method was applied to identify factors linked with burn injury. Injury prevalence was 6.2% (95% CI:5.5–6.8); and this burden was linked with several risk factors such as lower literacy status of caretakers [AOR = 2.21 (95% CI:1.05–4.67)], overcrowding [AOR = 2.35(95% CI:1.25–4.43], lack of separate kitchen [AOR =2.19 (95% CI:1.56–3.07)], using traditional cookstove [AOR = 2.04 (95% CI:1.23–3.36)], and lack of child supervision [AOR = 2.27 (95% CI:1.63–3.17)]. In conclusion, children experience a high burden of burn injury. Thus, stakeholders should work to reduce child burn injury by modifying the aforementioned risk factors.

Admission Circulating Cell-Free DNA Levels as a Prognostic Factor in Pediatric Burns.

Background Burn injuries in children are a major physical and psychological trauma, often a severe condition with long-term consequences. Current methods of assessing the extent of burn injuries on admission are inaccurate. Circulating cell-free DNA (cfDNA) is a potential marker of tissue damage that may be useful in burn care. Objective To explore the use of cfDNA admission levels as a prognostic marker of pediatric burn severity and outcome. Methods cfDNA levels of 38 pediatric burn patients (otherwise healthy) and 12 matched pediatric controls (minor elective surgery patients) admitted to our center were quantified by a direct fluorometric assay. Results We found significantly higher admission cfDNA levels in the patient group (median 724 ng/ml, range 44-4405), compared to the control group (median 423 ng/ml, range 206-970, Mann–Whitney, P = 0.03) and a significant difference between cfDNA levels of partial-thickness burns (median 590 ng/ml, range 44-2909) and full-thickness burns (median 2394 ng/ml, range 528-4405, Mann–Whitney, P = 0.01). We also found significant correlations between cfDNA levels and hospitalization duration (Spearman, R = 0.42, P < 0.01) and undergoing surgical procedures (Spearman, R = 0.40, P < 0.01). PICU admission did not correlate to cfDNA levels (Spearman, R = 0.14, P = NS). Discussion. Admission cfDNA levels may be a valuable objective tool for assessing the severity of pediatric burn injuries on admission, including correlations with the length of hospitalization and surgical burden. Conclusion Admission cfDNA levels may be a promising novel pediatric burn assessment method. Further investigation of cfDNA levels in healthy children standardized to age and larger cohorts are needed to establish cfDNA as a valuable prognostic factor for pediatric burn injury.

Epidemiology of non-fatal burn injuries in children: evidence from Bangladesh Health and Injury Survey 2016

BackgroundBurn is a major cause of childhood injury-related morbidity and mortality. Global estimates suggest that 90% of all cases occur in low-income and middle-income countries and over half of the...

The experience of critical burn injury treatment in pediatric practice

Patients with severe burn injuries require specialized medical care. For many decades, burn injury in children remains an important issue both in medical and social-economic aspects. It is explained by the high frequency of this pathology, prevalence among all age groups of the population, severe clinical course accompanied by the multiple organ failure development. About 400 thousand burns per year occur in Russia, 3540% of them affect children. A burn injury often leads to fatal outcome, disability and reduce of the quality of life. Wound infection associated with the burn injury in children remains a topical problem of modern combustiology. The authors present the clinical case of successful treatment of Patient M., born in 2005. The patient was transferred from the city M. to the burn center of University Clinic of the Privolzhsky Research Medical University in Nizhny Novgorod on the third day after getting the injury. During the hospitalization period in the burn center, the patient underwent complex treatment: infusion-transfusion therapy under the hemodynamic and laboratory indicators control, antibacterial and anticoagulant therapy, nutritional support by a combined method, symptomatic treatment, active surgical tactics (necrectomy by bordering incisions using modern wound hydrocolloid coatings, autologous skin grafting). In skin grafting operations, a high perforation coefficient of split grafts was used (1:6, 1:3). The success of treatment was determined by the creation of an optimal wound environment for the autografts engraftment, the absence of regression, which made it possible to restore the skin integrity in a short time, and to avoid complications of the burn disease course. Thus, the early transfer of a child with a severe injury into a specialized burn center, intensive therapy, active surgical tactics, the use of modern wound coatings in the treatment of a patient with a critical area of deep burn injury made it possible to successfully restore the skin in a short time of hospitalization.

Intraoperative Methadone Use in Pediatric Burn Patients.

Burn injury in children can cause severe and chronic physical and mental sequelae. Opioids are a mainstay in burn pain management but increasing utilization in this country has led to concern for their continued use and potential for dependence. Methadone is a long-acting analgesic that targets the N-methyl-D-aspartate (NMDA) receptor in addition to the mu opioid receptor and has benefit in adult burn patients. However, its use in the pediatric burn population has been less robustly studied. This is a retrospective cohort study at a single Level 1 Burn Center whose primary aim is to compare opioid utilization 36 hours postoperatively between pediatric burn patients who received intraoperative, intravenous methadone and those who did not. Secondary aim was to describe differences in methadone-related complications between the cohorts. There was decreased opioid utilization measured by median morphine equivalents per kilogram (ME/kg) postoperatively in the methadone cohort compared to the control cohort (0.54 vs 0.77 mg/kg, P = .18). No adverse events were noted upon chart review. The data suggest that methadone use is beneficial in pediatric burn patients, but further prospective studies are warranted on a larger population.

Effectiveness of child burn prevention campaigns in Mongolia

ObjectiveTo evaluate the effects of child burn prevention campaigns on medically attended burn injuries in Ulaanbaatar, Mongolia.MethodsWe conducted an interrupted time-series analysis using data on patients aged<5 years who were...

Massive Pediatric Burn Injury: A 10-Year Review.

Advances in the care of burn-injured pediatric patients have improved mortality over the last 20 years. However, massive burn injuries (50% TBSA or greater) in pediatric patients, while overall rare, have a significant morbidity and mortality. The primary aim for this study is to analyze treatment and outcomes in massive pediatric burn injuries. A retrospective study of children with burn injuries 50% TBSA or greater who were admitted to Shriners Hospital for Children Northern California, from May 1, 2009 to May 22, 2020, was conducted. Data were collected from the electronic health records through a comprehensive chart review that included: patient demographics, past medical history, treatment interventions, and outcomes. This study included 69 patients (59.4% male) with a mean age of 8.7 ± 6 years. The median time from injury to admission was 2 (1-4) days. In this study, 63.8% of patients were from Mexico, 34.8% were from the United States, and 1% patient was from American Samoa. The median time from injury to admission was 2 (1-4) days. Mean TBSA was 66% ± 12%. The median TBSA of second-degree burns was 0 (0-6) %, and the mean TBSA of third-degree burns was 60% ± 16%. Forty percent of patients suffered an inhalation injury and 83% of patients received a tracheostomy. The median number of days requiring ventilator assistance was 26 (12-58) days. Mean length of hospitalization was 90 ± 60 days, with 61 ± 41 days spent in the intensive care unit. The mean number of surgical procedures was 6 ± 4. The time between surgical procedures was 12 ± 6 days. The median time from admission to the first surgical procedure was 1 (0-2) day. At the first procedure, a mean of 42% ± 15% TBSA of the burn injury was excised. Sixty-two percent of patients received autografting (22% ± 11% TBSA) and 52% of patients received allografting (27% ± 17% TBSA) during the first procedure. For survivors, the median number of inpatient occupational therapy encounters was 143.5 (83-215) and inpatient physical therapy encounters was 139.5 (81-215). Twenty-five percent of the patients included in this study died as a result of their burn injury. Multivariate regression revealed that sustaining an inhalation injury was a significant and independent predictor of death (odds ratio: 3.4, 95% confidence interval: 1.05 to 11, P = .04). Massive burn injuries in children required a very high number of surgical procedures and hospital resources. Most children who died as a result of their massive burn injury died within the first month of admission. Inhalation independently increases the risk of dying in pediatric patients with a massive burn injury.

Who manages burn injuries in children? A program director survey evaluating burn training during pediatric surgery fellowship

PurposeBurn is one of the leading causes of injury and death in children. Currently, the Residency Review Committee does not require general surgery residents to rotate on a burn service. With many trainees no longer receiving burn training during residency, we sought to evaluate the exposure to burn management in pediatric surgery training programs. Material and methodsAn electronic survey was sent to program directors at accredited pediatric surgery training programs (56) during the 2020 academic year. Case log reviews were performed for 2005-2019. Descriptive statistical analysis was performed. ResultsThirty-six program directors participated in the survey (64%), and 56% reported having an inpatient and outpatient component for burn management. Nearly 20% of program directors reported having no burn management at their institution. Fifty-four percent of responding programs had fellow participation in burn management. Over a fifteen-year period, case logs identified a median of 0–2 burn cases logged each year for graduating fellows. Logistically, 65% of burn centers relied on general pediatric surgeons for management. ConclusionPediatric surgery trainee involvement in burn management varies with many programs offering no designated burn training. Increasing exposure to pediatric burn management during training is needed to provide improved care for this patient population. Level of evidenceIII, Retrospective Review

An Exploratory Study Demonstrating That Salivary Cytokine Profiles Are Altered in Children With Small Area Thermal Injury.

Serum can be used to investigate changes in cytokine concentration following burn injury in children; however, for children receiving treatment in an outpatient setting, blood is not routinely collected and therefore cannot be used for monitoring. The aim of this study was to investigate the use of saliva as a noninvasive tool for predicting burn outcomes by measuring the concentration of salivary cytokines in children with small area burns. A multiplex cytokine assay was used to measure 17 cytokines in the saliva of pediatric patients with burns (n = 20) and healthy controls (n = 20). After the removal of cytokines that had >30% of samples below the assay lower detection limit, six cytokines including IL-1β, IL-4, IL-7, IL-8, MCP-1, and TNFα were analyzed for association with burns. IL-1β and IL-4 were found to be significantly elevated in the pediatric burn patients compared to healthy controls. Interestingly, IL-1β was also significantly elevated in scald burns, compared to contact burns. In addition, biologically meaningful differences in cytokine concentration were identified in patients with different burn characteristics, which warrant further investigation. This exploratory study provides evidence that cytokines can be detected in the saliva of children and that salivary cytokine profiles differ between healthy controls and children with burns. Overall, this study demonstrates the value of saliva for the investigation of cytokines and its potential application in pediatric diagnostics, specifically in situations where blood collection is not appropriate.

Understanding burn injuries in children—A step toward prevention and prompt first aid

This study was designed to examine knowledge, attitude and practices with regards to burns prevention and first aid in the Indian community.A total of 83 caregivers aged 19 and 40 years (mean 29 years) participated in survey. Sixty-one percent of those who responded to the survey had some knowledge of first aid, mostly through health education at schools (59%). Very few (2%) received first aid education from health workers. Approximately 2/3 of responders (66–70%) were aware of applying cool running water to a burn and to stop drop and roll in case of a flame burn. However, the same number also listed a myriad of household remedies that they would use as first aid. 66–71% responders were aware of some situational risks in the home and community but only 27% considered young children to be at greater risk. 31% responders had an enclosed kitchen and 16% were still cooking on the floor. A large percentage (83%) cooked outside on a traditional wooden open fire. A quarter of the responders still used oil lamps on the floor and had little regard for the flammability of clothes.There was a weak positive correlation between knowledge and attitude (r-square 0.379) and attitude and practice (r-square 0.373), but no correlation between knowledge and practice (r-square 0.089).Our survey suggests that many responders have limited knowledge of effective first-aid techniques and live in high-risk environments. The major sources of first aid information were from school-based health education, social and electronic media. These resources can be utilized to further disseminate knowledge on first aid and practical prevention techniques.

Prospects for improving primary health care to children with thermal injuries

Introduction. Burn injury in children has been and remains one of the most significant cause of disability and death in the world. An important aspect in relation to the prognosis and course of the wound process is the quality of the first aid provided at the prehospital stage. Untimely diagnosed shock, inadequately prescribed anesthesia, attempts to perform surgical treatment of wounds at the site of the accident can fatally affect the prognosis of the disease.Material and methods. A retrospective analysis of medical documentation of 328 children who were treated at the burn center from 2016 to 2019 was made. Selection criteria were: arrival to the center by ambulance, shock, transfer to ICU. To analyze actions performed in the prehospital stage, a number of parameters were identified: diagnosis, length of transportation, specialists in the ambulance team, TBSA (total burn surface area), thermal inhalation lesion, and others.Results. The overwhelming majority of errors refer to diagnostics: shock (94.5%), incorrect TBSA assessment (63.7%), inadequate pain relief (61.9%), etc. A reliable correlation was revealed between ineffective analgesia and incorrect assessment of thermal lesion area. Life-threatening conditions develop in case of incorrect primary surgical treatment of wounds, incorrect vascular puncture, tracheal intubation, etc.Conclusions. The revealed difficulties in providing the primary medical aid to burnt patients at the site of accident require the development of a clearer and more understandable algorithm for medical personnel who provide the first aid to children with burns.

Epidemiological analysis of burn injuries in children during the first COVID-19 lockdown, and a comparison with the previous five years

BackgroundChild burns rank among the most frequent domestic accidents in France. COVID-19 lockdown between March 16th and May 11th of 2020 increased time spent at home by children.MaterialThis retrospective, observational study described the epidemiological impact of COVID-19 lockdown on child burns in a pediatric surgery department compared with previous five years. Child burns in the previous five years constituted the “before COVID-19 group” as the reference group. Child burns during the first lockdown formed the “COVID-19 group”. Demographics characteristics, the delay before first attendance at the surgery department, burns characteristics, the place of the incident, need of skin graft, and child reactions to trauma or isolation were recorded for these two groups.ResultsA total of thirty-seven children were included, 16 of them in the COVID-19 group. In the COVID-19 group, burned children were mainly boys, with a median age of 18 months. The median time before first attendance was four days. Main burns characteristics were to be deep partial thickness burns, involved lower limbs, caused by scalding. All burns occurred at home. Half parents reported child reactions to trauma or isolation among their children before burn injury.ConclusionThe incidence of child burn injuries in the COVID-19 group was higher compared to the before COVID-19 group, but no increased delay to attendance recorded. Time spent at home and psychosocial impact of lockdown might partially explain this high incidence rate of child burns.Level of evidenceIV.

Pattern of Burn Injury in Children Presented to Dhaka Shishu (Children) Hospital

Background: Children are mostly affected in burn injury at our country like other low and middle income countries (LMICs). Approximately 90% of the burns occur in under developed countries, which generally lack the necessary infrastructure to reduce the incidence and severity of burns.&#x0D; Objectives: This study was done to investigate the pattern of burn cases admitted to Dhaka Shishu (Children) Hospital (DSH).&#x0D; Methods: This was a retrospective study conducted over the period of one year from January 2019 to December 2019 at Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh. The data was collected from the patients record section of the hospital. Patients characteristics (e.g. age, sex), causes and severity of injury, outcome, hospital stay and seasonal variation were analized in this study.&#x0D; Results: A total of 91 patients were admitted during study period of one year. This study consisted of 53 male patients (58.24%) and 38 female patients (41.76%) with male to female ratio of 1.3:1. The most frequently hospitalized burn patients were in the age group 3-5 years, which accounted for 30.77% of patients. Burns were more common during winter season followed by autumn season, with 43 cases (47.25%) and 18 cases (19.78%) respectively. The highest number of admissions was during the month of December. Scald burn was the most common cause of burn injury in our study which accounted for 83 cases out of 91 cases (91.2%). Flame burn occured in 3(3.29%) patients. There were 2 cases of electric burn and 2 cases of contact burn during this study period. One patient was with chemical burn. Scald burn was the most common cause of burn injury in this study which accounted for 83 cases out of 91 cases (91.2%). Flame burn occured in 3(3.29%) patients. There were 2 cases of electric burn and 2 cases of contact burn during this study period. One patient was with chemical burn.&#x0D; Conclusion: The most frequently hospitalized burn patients were in the age group 3-5 years and more common during winter season. Most of the burn occured in children are scald in our country due to accidental fall of worm liquid. Superficial epidermal and dermal burns are treated conservatively, but deep burns may require surgical treatment.&#x0D; DS (Child) H J 2020; 36(2): 134-137

Aetiology of severe burn incidents in children under 5 years of age in the Netherlands: A prospective cohort study

BackgroundRisk factors and mechanisms of injury may change over time. Since knowledge on aetiology of severe burn incidents in children under 5 years of age in the Netherlands is outdated, this study aimed to identify current risk factors and mechanisms of severe burn injury in children under 5 years of age in the Netherlands to direct future prevention campaigns. MethodsInformation on personal-, environmental- and behavioural circumstances as well as the mechanism of burn injury was prospectively collected in all burn centres during one year from patient records and structured interviews with parents. ResultsBoys around 18 months of age, who, while in upright position, pulled down a cup of hot tea over themselves, were overrepresented. Children in families with more children, having a migration background, living in urbanised neighborhoods or with a low socioeconomic status (SES) are at increased risk for severe burn injury. Most incidents happened in their own home with the parents in close proximity to the child. ConclusionOutcomes of this prospective cohort study provide up-to-date and extensive knowledge on the aetiology of severe burn incidents in children under 5 years of age in the Netherlands, and provide directions for prevention policy and campaigns.

Parental acceptance and willingness to pay for a newly designed kitchen rack to reduce paediatric burns

The majority of pediatric burns in Mongolia occur within the home, particularly in the spaces dedicated to cooking. This makes home environment modification a priority for injury prevention. Many of these injuries are caused by electric appliances used in traditional tent-like dwellings (called a ger). In the present study, we designed and provided a context appropriate kitchen rack to 50 households with children aged 0–3 years living in gers and investigated parental views on the acceptability of the rack and willingness-to-pay (WTP) through face-to-face structured individual and group interviews and the contingent valuation method. We used the DCchoice package of R to estimate the median WTP and its 95% confidence interval by the household income, previous experience of childhood burn injury, and the number of children in the household. There was a total of 89 children aged <5 years in the 50 households, with a total of 59 burn experiences since birth including 29 treated at inpatient facilities. The median WTP was MNT 106,000 (about USD 37). The WTP appeared to be higher for the households with a higher income, more severe child burn experiences, and a greater number of children in the household. In the group interviews conducted after 4–6 weeks of routine use, the participants indicated that the use of the rack had resulted in a less stressful cooking environment, and the kitchen rack was described as a positive contribution to the reduction of risk to their young children. Whilst there were some suggestions for minor modifications, the rack was well accepted as a means of child burn prevention by the parents of infants and toddlers in Mongolia.

Shisha related burns: A paediatric case series

IntroductionThe majority of burn injuries in the paediatric age group occur in the home environment and are preventable. Water pipe smoking, commonly known as shisha, is an old practice of tobacco smoking dating from the 16th century with the use of hot coals and water in social gatherings at homes or cafes. The increasing use of shisha worldwide in youth raises public health concerns regarding its detrimental health effects and potential for serious thermal injury. Our aim is to identify and classify epidemiological trends of shisha related burns in the paediatric age group across New South Wales and the Australian Capital Territory. MethodsA retrospective review from January 2009 – December 2019 at The Children’s Hospital at Westmead Burns Unit. All burn injuries of age less than 16 years that attended or were referred to the unit were included in this study. ResultsThere were 10 patients who presented with a shisha related burn injury. There was an equal distribution of males to females with all burns occurring in the home or a park. The most common types of injury were a full thickness or mid-dermal burns respectively, three of which required split thickness skin grafting. ConclusionsShisha smoking is part of many cultures that has many potential burn hazards to children and family. Educational awareness targeted to shisha users can bring a better understanding about its potential for burn injury in children.

Risk factors for cooking-related burn injuries in children, WHO Global Burn Registry.

ObjectiveTo assess the characteristics of cooking-related burn injuries in children reported to the World Health Organization Global Burn Registry.MethodsOn 1 February 2021, we downloaded data from the Global Burn Registry on demographic and clinical characteristics of patients younger than 19 years. We performed multivariate regressions to identify risk factors predictive of mortality and total body surface area affected by burns.FindingsOf the 2957 paediatric patients with burn injuries, 974 involved cooking (32.9%). More burns occurred in boys (532 patients; 54.6%) than in girls, and in children 2 years and younger (489 patients; 50.2%). Accidental contact and liquefied petroleum caused most burn injuries (729 patients; 74.8% and 293 patients; 30.1%, respectively). Burn contact by explosions (odds ratio, OR: 2.8; 95% confidence interval, CI: 1.4–5.7) or fires in the cooking area (OR: 3.0; 95% CI: 1.3–6.8), as well as the cooking fuels wood (OR: 2.2; 95 CI%: 1.3–3.4), kerosene (OR: 1.9; 95% CI: 1.0–3.6) or natural gas (OR: 1.5; 95% CI: 1.0–2.2) were associated with larger body surface area affected. Mortality was associated with explosions (OR: 7.5; 95% CI: 2.2–25.9) and fires in the cooking area (OR: 6.9; 95% CI: 1.9–25.7), charcoal (OR: 4.6; 95% CI: 2.0–10.5), kerosene (OR: 3.9; 95% CI: 1.4–10.8), natural gas (OR: 3.0; 95% CI: 1.5–6.1) or wood (OR: 2.8; 95% CI: 1.1–7.1).ConclusionPreventive interventions directed against explosions, fires in cooking areas and hazardous cooking fuels should be implemented to reduce morbidity and mortality from cooking-related burn injuries.