Burns In Children Research Articles

Parental adjustment to a burn-injured child: how to support their needs in the aftermath of the injury.

The physical pain of a burn is immeasurable, but the pain of seeing a child suffer is indescribable. Childhood burns not only affect the child directly, but also have a significant impact on the parents and the rest of the family. During the acute phase of the burn, the child's main allies in recovery are their parents, so they face emotional turbulence, having to support their children while witnessing the painful procedures they go through. They often feel helpless and distressed because they are unable to protect their children from suffering and have difficulty managing everything they feel. In addition to the often-present feeling of guilt, they also experience sadness and worry, particularly when returning home. After hospital discharge, fears increase, as do the challenges. There is a need to readapt the entire family dynamic to respond to the needs of the burned child who returns home. This readaptation often generates stress and anxiety, interfering with the entire family structure. It is crucial to try to understand these parents and give them all the support they need. Only capable and well-adjusted parents can ensure resilient family environments with safer and calmer children, thus promoting family well-being. In this perspective paper, the authors underline the role of parents of burnt children during the long trajectory of child rehabilitation and recovery. By acknowledging their needs, feelings and challenges healthcare providers can engage and support suffering parents toward more family-centered approach.

Burns in Children and Adults Surgery Department Sikasso Hospital

Burns in Children and Adults Surgery Department Sikasso Hospital

Childhood burn injury in the ger districts of Ulaanbaatar, Mongolia: an analysis of parent narratives

Childhood burns pose a significant public health concern, particularly in low- and middle-income nations, where the burden is pronounced. Mongolia stands out for its elevated rates of burn-related child mortality, especially among 1 to 5-year-olds. Despite this, there is a lack of research on the current status of childhood burns in Ulaanbaatar. This study utilized Cognitive Edge’s Sensemaker® to collect micronarratives from parents in the ger districts of Ulaanbaatar, aiming to understand the present context of childhood burn injuries. Thematic analysis revealed four key themes, including features in home and outdoor environments, lack of safety measures, and limitations in supervision. The findings emphasize the need for a comprehensive approach to burn injury prevention tailored to the Mongolian context. Implementing suitable safety measures in ger districts based on these results could be instrumental. Additionally, extending this approach to other low- and middle-income countries warrants further investigation for effective preventive measures.

Outcomes of Colonic and Gastric Tube Transplants after Caustic Esophageal Burn in Children: A 33-Year Review.

Introduction: Accidental caustic burns of the esophagus in children represent a significant global health challenge, often necessitating esophageal reconstruction. The aim of this study is to compare the efficacy and morbidity related to esophagus replacement with colonic and gastric tube transplants in a pediatric population followed for caustic stenosis. Methods: This retrospective study was conducted at a tertiary pediatric surgery unit for children treated from January 1989 to December 2022. We compared colonic and gastric tube esophageal replacement. Short term (within 30 days) and mid-term outcomes and complications were reviewed. Statistical evaluation was considered using a Chi-square test for categorical data analysis. Results: A total of 124 children with caustic esophageal burns were included. Among them, 23 (18.5%) had a gastric tube transplant for esophagus replacement and 101 (81.5%) a colonic transplant. During surgical intervention, we found a significantly higher risk of complications when using a colonic transplant (34%, p < 0.001). There was no significant statistical difference in postoperative short term and mid-term complications between the two techniques. Twenty-six (26%) of the children required a reoperation, with a higher risk in the gastric tube transplant group (p < 0.001). Endoscopic dilatation after surgery was also performed on a higher number of children who had received a gastric tube transplant (p = 0.005). Overall, 97.6% recovered full normal oral feeding. Conclusions: We found that colonic and gastric tube replacement are both good options for pediatric esophageal replacement after a caustic injury and show effectiveness over time. Gastric tube transplants carried a slightly higher risk of reoperations and a higher number of dilatations post-surgery. However, our groups are not really comparable, due to the much higher number of colonic transplants. Both surgical options have to be considered during surgery, and the choice depends on the anatomy of the patient. Our future research will focus on assessing long term quality of life and the potential risk of neoplastic complications.

Challenges Faced by Parents of Pediatric Burn Survivors: A Thematic Analysis

Background: Burn injuries compromise the integrity of skin, its appendages, and underlying tissues due to exposure to various agents including dry and moist heat, corrosive substances, and high voltage electric currents. Particularly in the pediatric population, these injuries not only affect the children but also significantly impact the lives and health of their parents. Objective: This study aimed to explore the multifaceted challenges faced by parents of pediatric burn survivors at the Burn and Plastic Surgery Center in Hayatabad KPK Peshawar. Methods: Employing a qualitative case study design, this research involved 10 participants selected via purposive sampling. Data collection was conducted through face-to-face in-depth interviews using a semi-structured interview guide. All interviews were audio-recorded, with non-verbal cues and expressions meticulously documented. Thematic analysis was utilized to derive codes, categories, and subsequently, themes from the data. Results: Analysis revealed five major themes reflecting the challenges encountered by parents: socio-economic difficulties, psychological distress, physiological and physical health issues, spiritual anxiety with altered religious activities, and domestic violence and abuse. Specifically, 70% of participants experienced significant disruptions in their daily lives and interactions, while 100% reported financial hardships directly affecting their ability to manage the health care needs of their children. Conclusion: The study underscores the extensive challenges that parents of pediatric burn survivors face, highlighting the necessity for healthcare professionals to adopt a holistic approach in treating burnt children while concurrently addressing parental difficulties. Effective identification and management of these challenges are crucial to improving health outcomes for both the children and their parents.

BRULURE CUTANEE CHEZ LES ENFANTS : ASPECTS CLINIQUES ET THERAPEUTIQUES DANS LE SERVICE DE CHIRURGIE GENERALE DE L’HOPITAL IGNACE DEEN CHU DE CONAKRY.

A burn is an injury to the skin covering and underlying structures caused by a thermal, electrical, radioactive or chemical agent. Objective: To study the clinical and therapeutic aspects of childhood skin burns in a Conakry university hospital. Methodology: This is a 4-year retrospective descriptive study from January 2018 to December 2021. We identified 55 burn patients. The average age was 3.16±2.85 years. The male gender was the most affected (n=33; 60%). Results: The burns were thermal in 80% of cases, hot liquid was the dominant causal agent with 85.45% of cases. We observed a dominance of second degree burns in 85% of cases. These burns were accidental in 100% of cases and occurred at home in 84% of cases. Treatment was medical and combined rehydration, antibiotic therapy and analgesia. Trimming and/or dressing was performed under general anesthesia for 26 patients (34.6%). A discharge aponeurotomy on the forearms wasperformed in 2 patients or 2.6% of cases. The evolution was favorable in 72.7% of cases. Seven children died Conclusion: Childhood burns occur at home and are mainly caused by thermal liquids. Clinically, it mainly causes second-degree lesions. Its treatment is medical and based on good rehydration associated with adequate antibiotic therapy and analgesia. Surgical care involves trimming and aponeurotomy. Keywords: burn, child, thermal agent, medical treatment

Inspiratory muscle training impact on respiratory muscle strength, pulmonary function, and quality of life in children with chest burn: A randomized controlled trial

PurposeRespiratory muscle function is compromised in children recovering from chest wall burns, which potentially leads to more impact on exercise capacity and quality of life. This study investigates the effects of an inspiratory muscle training intervention accompanied with a pulmonary rehabilitation program on respiratory muscle strength, lung function, functional capacity, and quality of life in chest burned children. MethodsForty children with burns, aged from 10 to 18 years old and total body surface area of 30% to 50%, were randomly allocated to the inspiratory muscle training group (IMT- G: n = 20) or control group (CG: n = 20). They received IMT plus pulmonary rehabilitation or pulmonary rehabilitation with sham IMT, respectively for eight weeks. The outcomes were the respiratory muscle strength measured by maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP); lung functions (FEV1, FVC and FEV1/FVC ratio); functional capacity as well as Pediatric Quality of Life to measure physical and psychosocial functioning. outcome measures were assessed at before and after intervention (after eight weeks). ResultsBased on the pre-intervention assessments, we found no significant difference between both groups (p > 0.05). Significant post-intervention differences were reported between both groups in MIP (P = .003), MEP (P = .017), FVC (P = .001), FEV1 (P = .007), FEV1/FVC ratio (P = .028), functional capacity (P = .003), physical domain of QoL (P = .006) and psychological domain of QoL (P = .002) in favor of the IMT group. ConclusionsEight weeks of inspiratory muscle training combined with pulmonary rehabilitation program improved children with chest burns' respiratory muscles strength, lung functions, functional capacity, and quality of life. Inspiratory muscle training may be employed in burn rehabilitation programs. It is a safe and effective therapy in chest burned children.

Gamificação na prevenção de queimaduras: desenvolvimento de um jogo infantil

Burns are a public health problem and result in physical, psychological as well as social repercussions, leading to death. The objective of this study is to develop a game that can distribute information, with the focus on burn prevention and serving as an alternative for health education. This is technological research for the experimental development of a game focusing on the prevention of childhood burns and using the problematization method based on the Maguerez Arch. Gamification is an innovative alternative for training and for behavioral changing and health education is a strategic tool that helps and strengthens care. The game was made for children aged six to ten years old and will be made available in a virtual environment for Android devices. Assistance from a programming language professional was required to program the game. Nowadays, it is necessary to keep up with innovations and technologies, improving interaction with children.

Pediatric Trauma Recidivism: A Statewide Risk Factor Analysis of the Maryland Health Services Cost Review Commission (HSCRC)

BackgroundNational estimates suggest pediatric trauma recidivism is uncommon but are limited by short follow up and narrow ascertainment. We aimed to quantify the long-term frequency of trauma recidivism in a statewide pediatric population and identify risk factors for re-injury. MethodsThe Maryland Health Services Cost Review Commission Dataset was queried for 0–19-year-old patients with emergency department or inpatient encounters for traumatic injuries between 2013 and 2019. We measured trauma recidivism by identifying patients with any subsequent presentation for a new traumatic injury. Univariate and multivariable regressions were used to estimate associations of patient and injury characteristics with any recidivism and inpatient recidivism. ResultsOf 574,472 patients with at least one injury encounter, 29.6% experienced trauma recidivism. Age ≤2 years, public insurance, and self-inflicted injuries were associated with recidivism regardless of index treatment setting. Of those with index emergency department presentations 0.06% represented with an injury requiring inpatient admission; unique risk factors for ED-to-inpatient recidivism were age >10 years (aOR 1.61), cyclist (aOR 1.31) or burn (aOR 1.39) mechanisms, child abuse (aOR 1.27), and assault (aOR 1.43). Among patients with at least one inpatient encounter, 6.3% experienced another inpatient trauma admission, 3.4% of which were fatal. Unique risk factors for inpatient-to-inpatient recidivism were firearm (aOR 2.48) and motor vehicle/transportation (aOR 1.62) mechanisms of injury (all p < 0.05). ConclusionsPediatric trauma recidivism is more common and morbid than previously estimated, and risk factors for repeat injury differ by treatment setting. Demographic and injury characteristics may help develop and target setting-specific interventions. Level of EvidenceIII (Retrospective Comparative Study)

‶Don’t Say Neigh, Say Yay”

‶Don’t Say Neigh, Say Yay”

Effect of a Childhood Burn Prevention Program on Knowledge Level of Caregivers and Burn Risk Factors

BackgroundPrevention activities are very important in paediatric burns. More than 73% of burns occur at home. This study aimed to develop a Childhood Burn Prevention Program for caregivers of children with burns and to evaluate the effectiveness of the program for reducing burn risk factors for children at home as well as increasing the relevant knowledge of caregivers on burn prevention. Methods“Childhood Burn Prevention Program” was developed in the study. Within the scope of the program, caregivers were interviewed twice at home visits. At the first home visit, caregivers were trained in burn prevention and a poster including burn risk factors was put in their homes. In addition, the knowledge levels of caregivers about burns and risk factors in home settings were evaluated in the first and second home visits. ResultsWe found the total risk factor for burns in home settings was 28.94 ± 6.24 before the training and 14.68 ± 3.74 after the training (p < 0.05). In addition, the total number of correct answers given by the caregivers to the questions about burns before the training was 8.60 ± 2.62 and 11.71 ± 1.70 after the training (p < 0.05). ConclusionThis Childhood Burn Prevention Program can be used to reduce risk factors for burns at home and to increase the relevant knowledge of caregivers of children.

A wellbeing program to promote mental health in paediatric burn patients: Study protocol.

One of the most traumatic injuries a child can experience is a severe burn. Despite improvements in medical treatments which have led to better physical outcomes and reduced mortality rates for paediatric burns patients, the psychological impact associated with experiencing such a traumatic injury has mostly been overlooked. This is concerning given the high incidence of psychopathology amongst paediatric burn survivors. This project will aim to pilot test and evaluate a co-designed trauma-focused intervention to support resilience and promote positive mental health in children and adolescents who have sustained an acute burn injury. Our first objective is to collect pilot data to evaluate the efficacy of the intervention and to inform the design of future trauma-focussed interventions. Our second objective is to collect pilot data to determine the appropriateness of the developed intervention by investigating the changes in mental health indicators pre- and post-intervention. This will inform the design of future interventions. This pilot intervention study will recruit 40 children aged between 6-17 years who have sustained an acute burn injury and their respective caregivers. These participants will have attended the Stan Perron Centre of Excellence for Childhood Burns at Perth Children's Hospital. Participants will attend a 45-minute weekly or fortnightly session for six weeks that involves building skills around information gathering, managing reactions (behaviours and thoughts), identifying, and bolstering coping skills, problem solving and preventing setbacks. The potential effects and feasibility of our intervention will be assessed through a range of age-appropriate screening measures which will assess social behaviours, personal qualities, mental health and/or resilience. Assessments will be administered at baseline, immediately post-intervention, at 6- and 12-months post-intervention. The results of this study will lay the foundation for an evidence-based, trauma-informed approach to clinical care for paediatric burn survivors and their families in Western Australia. This will have important implications for the design of future support offered to children with and beyond burn injuries, and other medical trauma populations.

High rate of negligence induced burns in children: A rising cause for concern of the world's burn community

One of the most important causes of death in burn patients is burn [1-10]. Accurate evaluation, timely diagnosis, and proper treatment of burn patients can reduce their mortality rate [11-21]. On the other hand, one of the most important causes of injury among children aged 1 to 15 is burns [22]. Usually, children and teenagers are more vulnerable in burn injuries than other age groups [23]. Severe burns can affect children's health both in the acute stage of burns and in the later stages of their lives [24]. Burns in children often occur due to injuries caused by hot liquids. The mechanism of burns among children can be due to exploratory behaviors without understanding the dangers in the environment [25]. Most burn injuries are due to accidental causes, but in some cases, it can be due to negligence in children [22]. It is difficult to distinguish whether the burn was accidental or caused by negligence [24]. Burn hospitalizations and deaths due to negligent burns are more than accidental burns. The interesting point is that some cases of children's burn injuries can be due to misbehavior and negligence that were not diagnosed at the time of admission. Identifying these people is important because preventive efforts by health care teams for children are necessary [22]. Hence, most negligence induced burns in children are preventable because negligence and carelessness are the main causes of burns in them [24]. The consequences of negligence induced burns in children can have physical, mental, and emotional effects on children and their families [23]. Burn scars often persist after healing and lead to functional and aesthetic problems [24]. On the other hand, psychological care after burns should be considered; because, children experience a high level of acute stress, anxiety, and depression after burns, and hospitalization can be scary for children [23]. The negative consequences of negligence induced burns in children in the long term can lead to chronic diseases in childhood and even adulthood. Therefore, special attention should be paid to the timely prevention, diagnosis, and treatment of negligence induced burns in children [22]. However, previous evidence regarding negligence induced burns in children is very limited. Hence, one study showed that 56% of burns in children were due to negligence [24].

Temporal trend, regional distribution and profile of morbidity and mortality due to childhood burns in Santa Catarina: An ecological study

Temporal trend, regional distribution and profile of morbidity and mortality due to childhood burns in Santa Catarina: An ecological study

42783 Contrasting the Management and Outcomes of External Body Surface Burns in Children and Adults

42783 Contrasting the Management and Outcomes of External Body Surface Burns in Children and Adults

A comprehensive approach to the delayed treatment of post-burn facial scars

BackgroundDamage to the skin and underlying tissues due to thermal burns is relevant. Despite the success of modern medicine, repairing thermal damage to the skin is a difficult task in reconstructive plastic surgery because of the nature of the damage and the regenerative features. Characteristic post-burn changes are associated with different depths of damage when areas of deep damage are combined with more superficial areas. MethodsWe described a clinical case of the staged surgical treatment of a cicatricial deformity of the buccal-periorbital-perioral region resulting from a childhood burn injury from a hot object. The 44-year-old patient complained of an aesthetic and functional deformity of the buccal-periorbital-perioral region and had previously undergone repeated nonsurgical corrections. ResultsA comprehensive approach to the surgical treatment of a patient with post-burn deformities using a diplene adhesive membrane directly affected the stage of the surgical treatment and contributed to improved functional and aesthetic results. ConclusionThe positive treatment results with preserved contraction and relaxation processes of the facial muscles as well as satisfactory aesthetic results allow us to recommend the use of a biodegradable diplene film during facial reconstructive operations.

Sedoanalgesia in the Debridement of Pediatric Burns in the Emergency Department: Is It Effective and Safe?

The routine use of sedoanalgesia has increased the number of potential minor surgical procedures that can be performed in the Emergency Department (ED) without requiring general anesthesia and, thus, hospital admission. Our aim is to analyze the effectiveness and safety of the use of sedoanalgesia in childhood burns treated in the ED. A retrospective study was conducted in burned children in whom burn debridement was performed under sedoanalgesia in the ED between 2017 and 2021 in a tertiary referral center for burns. We collected demographic variables, burn features and the type of sedoanalgesia performed in each case, including its effectiveness and associated adverse effects. A total of 227 patients (118 males, 109 females) were included, with a median age of 25 months. In total, 99.2% of the burns were thermal (69.2% scald burns), with a mean total body surface area (TBSA) burned of 4%. The most commonly used drugs were intravenous ketamine (35.7%), intravenous ketamine + midazolam (15.4%), intranasal fentanyl + midazolam (14.1%) and intranasal fentanyl (10.6%). The effectiveness of sedoanalgesia was considered satisfactory in 95.2% of the cases, with an adverse effect rate of 7.5%, without severe adverse effects reported. The use of sedoanalgesia in the ED in the early treatment of childhood burns achieves high effectiveness and safety. It is postulated as a quality indicator; thus, it should be known by all pediatric healthcare practitioners.

Effectiveness of Aloe Vera Gel in Management of Superficial Burn in Children

Background: Aloe vera has been used traditionally for healing burn and inflammation. Though, the evidence for the effectiveness of aloe vera for healing burn is not sufficient.&#x0D; Objective: The aim of this study was to assess the effectiveness of aloe vera gel in management of superficial burn in children.&#x0D; Methods: This retrospective study was taken place in the Department of Burn and Reconstructive Surgery, Bangladesh Shishu Hospital &amp; Institute, Dhaka and other two privet clinics at Dhaka, from September, 2019 to March, 2022. Total 47 patients with superficial partial thickness burn was included in the study.&#x0D; Results: In this study, majority (48.94%) patients were belonged to the age group of £24 months. The mean age was found 38.9±26.31 months. The current study observed that almost two third (61.70%) patients were male. In our study, majority (63.83%) patients stayed hospital for 1-5 days. In the present study, mean (±SD) pain relief time was 3.56±1.24 days and mean (±SD) wound healing time was found 8.19±1.6 days. The current study observed that only 3(6.38%) patients had found wound infection. In current study showed that mean treatment cost was found 76.46±31.88 Taka.&#x0D; Conclusion: Aloe vera gel facilitated early pain alleviation, wound healing, and costeffective superficial burn treatment in children. Therefore, it can be utilized to treat superficial burns in children to get better results.&#x0D; DS (Child) H J 2021; 38(1): 39-43

Dark side of customs: scalding burns in childhood due to use of traditional teacup and teapot, in Turkey

ABSTRACT The most common type of burn among children is scalding burn. This study aims to reveal child abuse and neglect as a specific etiological factor that specific to our country, traditional teapot- and teacup-related scalding burns. Burn cases that admitted to our Burn Center were investigated, and among these, 72 cases suffering from scalding burns were included in the study. The interview forms issued upon admission of these cases were evaluated in detail. Out of 148 scalding burn cases, 48.6% were related to the use of traditional teapots and teacups. After a detailed assessment, all cases were considered neglect-related burns. As a result of considering the role of traditional teapots and teacups in pediatric injuries in our country, parents and caregivers should be warned about these types of injuries. Also, physicians must determine the possibility of child abuse or neglect in all pediatric burn cases.

Effect of dry hydrogen peroxide on Candida auris environmental contamination

Background:Candida auris is an emerging pathogen that exhibits broad antimicrobial resistance and causes highly morbid infections. Prolonged survival on surfaces has been demonstrated, and standard disinfectants may not achieve adequate disinfection. Persistent patient colonization and constant environmental recontamination poses an infection risk that may be mitigated by no touch disinfection systems. We evaluated the efficacy of continuous dry hydrogen peroxide (DHP) exposure on C. auris environmental contamination. Methods: The study was conducted in a large tertiary-care center where multiple patients were identified as either infected or colonized with C. auris. DHP-emitting systems were installed in the ventilation systems dedicated to the adult burn intensive care and children’s cardiac intensive care units. Composite surface samples were collected in a sample of patient rooms and shared clinical workspaces among units with current C. auris patients, before and after installation of the DHP system, and from areas with and without exposure to DHP. The samples included “high touch” surfaces near the patient, the general area of the patient room, shared medical equipment for the unit, shared staff work areas, and equipment dedicated to individual staff members (Table 1). Presence of C. auris was determined by polymerase chain reaction (PCR). Association between DHP exposure and C. auris contamination was determined using the Fisher exact test. Results: In the presence of C. auris patients, 5 baseline samples per unit were taken before DHP was installed, and then 5 samples per unit were taken on days 7, 14, and 28 after installation. Prior to initiation of DHP, 7 (70%) of 10 samples were PCR positive for C. auris. After DHP installation, a statistically significant decrease to 5 (16.7%) of 30 samples (P &lt;.05) was observed. In total, 20 samples (5 before installation and 15 after installation) were collected from units without DHP on the same days. At baseline, 2 (40%) of 5 samples were PCR positive for C. auris. During subsequent periods, 4 (27%) 15 samples were positive (P = .66). No adverse effects were reported by patients, visitors, or personnel in association with the operation of the DHP systems. Conclusions: These findings suggest that DHP is effective in reducing surface C. auris contamination in a variety of patient and healthcare worker surfaces.Disclosures: None