Treatment Of Burns In Children Research Articles

Epidemiology and first aid measures in pediatric burn patients in northern China during 2016-2020: A single-center retrospective study.

Burn and scald injuries are the fourth most common type of trauma. Pediatric burns account for a high proportion of the total number of burn patients and impose a high burden on public health. Understanding the epidemiology of pediatric burns can help improve science education and reduce the incidence of burn injuries. This study is a single-center retrospective study. One thousand five hundred and twenty-seven pediatric burn patients admitted to our burn center from January 2016 to December 2020 were included. Demographic and epidemiological data of included patients were extracted and analyzed. The correlations of categorical data were tested by the Chi-square tests, and differences of continuous data were tested by the Kruskal-Wallis tests. A p-value of less than 0.05 was considered to be statistically significant. The results showed that children under 3 years of age were most susceptible to burn and scald injuries. Burn injuries were most likely to occur in the season of winter and at the place of home. 56.6% of included patients did receive first aid measures, while 1.8% received gold-standard first aid. Clinical variables related to the severity of injuries were statistically different between patients with and without cooling measures in first aid. Linear regression models showed that emergency treatment of burns in children and adolescents was associated with outcome indicators, including number of operations, total operation duration per total burn surface area (TBSA), cost per TBSA, and length of stay per TBSA. This study summarized the epidemiology and outcomes of pediatric burn patients admitted to a burn center in northern China. Adopting cooling measures in first aid can reduce the severity of injuries and reduce the burden on the medical system. Education on burn prevention and first aid measures to caregivers of children, especially preschool children, should be strengthened.

СОВРЕМЕННЫЕ ТЕНДЕНЦИИ ЛЕЧЕНИЯ ТЕРМИЧЕСКИХ ОЖОГОВ У ДЕТЕЙ

Burns in children are a significant pathology, despite strict measures and informing parents on the observance of safety rules in everyday life. Currently, the frequency of burns in children's institutions - kindergartens, schools and other places is minimized. But burns are often found in domestic conditions. According the date of different authors, burns are a global problem. Our purpose of the study was to analyze of literature and identify modern tendency in the management of childhood burns. According the analysis, the treatment of burns in children has undergone evolutionary changes from traditional methods (surgical treatment of wounds, local treatment of burn wounds using ointments and various wound dressings, necrectomy with immediate or delayed autodermoplasty) till to the use of mesenchymal stem cells of burn origin.

Nanocellulose-based wound dressing for conservative wound management in children with second-degree burns.

The initial care of burn wounds and choice of dressing are pivotal to optimally support the healing process. To ensure fast re‐epithelialisation within 10–14 days and prevent complications, an optimal healing environment is essential. An innovative dressing based on nanocellulose was used for the treatment of burns in children. Children (0–16 years) with clean, partial‐thickness burn wounds, 1 to 10% of the total body surface area were included. Complete re‐epithelialisation was achieved within 7–17 days, with 13 patients showing re‐epithelialised >95% by day 10. Satisfying results concerning time to re‐epithelialisation and material handling were obtained. The possibility to leave the dressing on the wounds for 7 days showed a positive effect in the treatment of children, for whom every hospital visit may cause massive stress reactions. The nanocellulose‐based dressing is a promising tool in conservative treatment of burns. Reducing the frequency of dressing changes supports a fast and undisturbed recovery; moreover, the dressing provides an optimal moist healing environment. The time to re‐epithelialisation is comparable to frequently used materials, and cost reduction effect can be achieved without loss of quality. Possible pain and distress levels are kept to a minimum; therefore, flexibility and compliance of the patients and their parents are enhanced.

Correspondence: Comment on ‘Randomized clinical trial of negative pressure wound therapy as an adjunctive treatment for small-area thermal burns in children’ by Frear et al

Correspondence: Comment on ‘Randomized clinical trial of negative pressure wound therapy as an adjunctive treatment for small-area thermal burns in children’ by Frear <i>et al</i>

The benefits of early surgical treatment of deep cervical burns in children

Background. The frequency of deep cervical burns in children is four times higher than that of deep face burns. Currently, there is no consensus on the methods for surgical treatment of deep burns in cervical areas; meshed skin autografts continue to be used.&#x0D; Aim. To evaluate the benefits of early surgical treatment of deep сervical burns in children between the third and fifth days from the moment of injury.&#x0D; Materials and methods. Case-control study. Surgical treatment was performed in 81 children with deep cervical burns. The main group with early surgical treatment included 46 children and underwent surgical treatment at 3.37 0.14 days from the moment of injury; the control group received autograft during stage treatment for 35 children at 27.17 0.18 days. The treatment results were evaluated by the following indicators: the number of dressing changes, the period of skin restoration, and the area of graft success. In the long term, functional and cosmetic treatment results were evaluated.&#x0D; Results. In the study and control groups, 7.93 0.45 and 18.75 0.61 dressings were required to complete the treatment, respectively (p 0.001). The skin restoration periods were 16.54 0.68 and 36.94 0.89 days, respectively (p 0.001). The graft success areas were 99.50% 0.13% in the main group and 93.91% 2.68% in the control (p 0.001). During the staged surgical treatment, one patient showed a loss of 90% of the graft, which required regrafting. Other complications in the treatment process have not been noted. When assessing long-term cosmetic results using the Vancouver Scar Scale, the average score was 4.0 0.26 points in the main group and 7 0.28 points in the control (p 0.001). The presence of post-burn cicatricial contracture in the main group was noted in 12 (26%) people and the absence in 34 (74%) children. In the control group, 20 (57%) patients required surgical removal of post-burn deformity, and 15 (43%) children did not need further surgical interventions.&#x0D; Conclusions. Early surgical treatment of deep cervical burns in children on the third and fifth days from injury allows not only to accelerate the process of restoration of the skin but also to directly affect the cosmetic and functional results in a better way.

Study of negative\xa0pressure wound therapy as an adjunct treatment for acute burns in children (SONATA in C): protocol for a randomised controlled trial

BackgroundAlthough negative pressure wound therapy (NPWT) is widely used in the management of several wound types, its efficacy as a primary therapy for acute burns has not yet been adequately investigated, with research in the paediatric population particularly lacking. There is limited evidence, however, that NPWT might benefit children with burns, amongst whom scar formation, wound progression and pain continue to present major management challenges. The purpose of this trial is to determine whether NPWT in conjunction with standard therapy accelerates healing, reduces wound progression and decreases pain more effectively than standard treatment alone.Methods/designA total of 104 children will be recruited for this trial. To be eligible, candidates must be under 17 years of age and present to the participating children’s hospital within 7 days of their injury with a thermal burn covering <5% of their total body surface area. Facial and trivial burns will be excluded. Following a randomised controlled parallel design, participants will be allocated to either an active control or intervention group. The former will receive standard therapy consisting of Acticoat™ and Mepitel™. The intervention arm will be treated with silver-impregnated dressings in addition to NPWT via the RENASYS TOUCH™ vacuum pump. Participants’ dressings will be changed every 3 to 5 days until their wounds are fully re-epithelialised. Time to re-epithelialisation will be studied as the primary outcome. Secondary outcomes will include pain, pruritus, wound progression, health-care-resource use (and costs), ease of management, treatment satisfaction and adverse events. Wound fluid collected during NPWT will also be analysed to generate a proteomic profile of the burn microenvironment.DiscussionThe study will be the first randomised controlled trial to explore the clinical effects of NPWT on paediatric burns, with the aim of determining whether the therapy warrants implementation as an adjunct to standard burns management.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12618000256279. Registered on 16 February 2018.

378 Surgical Treatment of Perineal Burns in Children of Middle Income Country

378 Surgical Treatment of Perineal Burns in Children of Middle Income Country

Safety of recombinant human granulocyte-macrophage colony-stimulating factor in healing pediatric severe burns.

We explored the safety of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) for healing burns in children. Subjects were randomly assigned to two groups: the experimental group received external rhGM-CSF gel, and the control group received rhGM-CSF gel matrix components, applied to the burn surface. Neither group was given any other drugs that promote wound healing. Each day we recorded the pulse, body temperature, and respiration status in the two groups. We detected the blood routine, urine routine, and hepatic and renal function before the patients received drug treatment and after 72 h. The wound scab and healing states in the two groups were recorded every 4 days to evaluate wound healing rate and time taken for complete healing. Adverse reactions and their rate of occurrence were also recorded. The median time of healing was 15 days in the experimental group and 19 days in the control group (log-rank χ(2) = 5.139, P < 0.05). After 10 days, the experimental group healing rate was consistently higher than that of the control group (significantly different using intuitive analysis), suggesting the experimental group method was more effective. There were no obvious adverse reactions. There was no significant difference between the blood routine, urine routine, and liver and kidney function in the two groups before the treatment and after 3 days (P > 0.05). Compared with saline treatment of severe burns, rhGM-CSF can effectively shorten the healing time without significant adverse reactions, and is an effective and safe treatment for burns in children.

OPTIMIZATION OF RESULTS AND TREATMENT TIMING OF DEEP DERMAL BURNS IN CHILDREN

Untreated deep dermal burns in children are the cause of long-term treatment and severe cicatricial deformities, resulting in poor cosmetic results and greatly impairing functional outcome. The problem of optimizing the results and timing of treatment of deep burns in children in recent years has become particularly urgent. We observed 1853 children with III-A degree burns. Some of the children's burns healed spontaneously, which led to the development of scar deformities during the first six months after injury. Risk factors for their development, depending on the patient's age and location of the lesion, are pointed out. Other children underwent early tangential excision of eschar. The analysis of the treatment results showed that the use of early surgery in children with deep dermal burns can reduce treatment time, as well as significantly to improve the cosmetic and functional outcomes of trauma.

Burn Injuries in Children and the Use of Biological Dressings

Burns represent a significant cause of morbidity and mortality in children. In this article, a case discussion will serve as a platform for discussing the evaluation and treatment of burns in children. Use of various burn dressings such as hydrocolloids, polyurethane films, hydrogels, biosynthetic skin dressing, and biological dressings will be discussed.

Pediatric burn surgery

Since the beginning of the new century, significant advances in the treatment of burns are visible at all levels, both in burn surgery and all related disciplines. Surgery of burns has become less aggressive and invasive, with equal or better results, and it is ever more complex and extensive, now representing a separate entity. Pediatric burn surgery is an integral part of burn surgery and pediatric surgical ward for burns is separated from the same department for adults. At the same time, the standards for burn centers are very specific and prescriptive. Innovations in burn surgery such as a variety of new active dressings, cultivated skin, dermal and epidermal semisynthetic grafts, many new products for burn wound protection, hydronecrectomy, selective proteolytic necrectomy, etc. have resulted in new terminology, new guidelines and clinical pathways, creating new experiences, better survival and more options in treating patients with burns, especially those with extensive and life-threatening ones. Surgical treatment of burns in children is just one important link of teamwork approach.

Le pansement par exposition à l’air dans le traitement des brûlures de l’enfant

Acute burn is a more or less profound destruction of the skin envelope. The depth of the injury determines the severity of functional and aesthetic sequelae. Local care prevents the infection, factor of deepening of the burn. Currently the dressing used in most Burns centers is a bandage covering a bacterial product applied to the burn. The advantage of this dressing is to prevent the occurrence of local infection. In contrast, open-air method of treatment is based on the notions that the wound is infected. His purpose is to reduce the effects of infection by creating an unfavourable environment to the growth and multiplication of bacteria. The principle of this method is the formation over the burned area of an eschar. The eschar acts as a natural dressing to protect the injured area against infection. The residual skin islets are preserved. The surgical cleavage of the eschar is easy; the deep surface of the crust defines the surgical plan. Deep tangential excisions are not necessary. The implementation of this technique is easy and it is particularly well suited to pediatrics. Treatment is not painful and the child's activities are not hampered by bandages. Respect of the children's quality of life and medical-economic efficiency of this method give it a prominent place in the treatment of burns in children.

Treatment of sandal burns in children

Treatment of sandal burns in children

What are the Differences? - Treatment of Burns in Children Compared to Treatment in Adults

Burns in children are very common. In this article we would like to focus on those aspects of wound care and surgical treatment in burns which are special in the paediatric population. Especially in small children it is crucial to correctly estimate a burned area and to delay appropriate fluid resuscitation. Pain management in children is very important, we therefore recommend standing pain orders managed by the nursing team. Wound care should be as little stressful as possible and enable an excellent evaluation of the wound. Surgical coverage is needed in less than 40% of all scald paediatric injuries and should be done with unmeshed split thickness skin from the scalp. In major and massive burns in children one should opt for an aggressive excision of all deep burned areas within the first 4 to 5 days and for a temporary wound coverage before replacing it with meshed autologous skin transplantations and/or keratinocyte sheet grafts. Finally, rehabilitation is very important, it starts at the day of trauma and needs a multidisciplinary approach. Parents have to be involved early, need to be well taught and well trained to guarantee excellent long-term results in a growing child.

The use of dermal regeneration template in the treatment of burns in children

The use of dermal regeneration template in the treatment of burns in children

The use of dermal regeneration template in the treatment of burns in children

The use of dermal regeneration template in the treatment of burns in children

Treatment of severe foot burns in children

Only a few papers on the problem of foot burns can be found in the easily accessible scientific literature. In Central Asia foot burns are widespread, because many people, especially children, walk barefoot in summer, and because the heated sandal is still used for keeping warm in winter. In the Samarkand Inter-Regional Burn Center in Uzbekistan, the following method of treatment was developed: initial surgical debridement of the wound, necrectomy with application of chemotherapeutic medications and early necrectomy, the removal of necrotic tissues and preparation the wound for early autodermoplasty. This effective treatment method contributed to the restoration of foot function in patients, lessened their joint deformities and post-burn contractures/deformities, and also shortened their hospital stay.

Usage of autograft and allograft skin in treatment of burns in children

Large burns still present problems regarding the availability of enough autologous skin cover. The two Units have no experience in using cultured keratinocytes as a substitute for split skin grafts, as these are not available in the Kingdom of Saudi Arabia and are therefore not practical. At the same time, we have been obliged to abandon the use of human allograft skin from cadavers and other patients, because it is not acceptable in our culture. Our favoured method for resurfacing large burn areas in children is to use widely meshed autologous skin, overlaid with meshed allograft from a parent (to minimise the risk of HIV transmission). We report our experience using this technique in five children. The fate of the intermingled grafts has been followed clinically, and in some cases histologically. There has been long-term persistence of the parental skin without rejection and although allograft dermis appears to contribute to the final cover, the cellular elements of the parental skin apparently do not survive.

First world conference on the prevention and treatment of caustic esophageal burns in children 3–5 april 1996 Izmir

First world conference on the prevention and treatment of caustic esophageal burns in children 3–5 april 1996 Izmir

Treatment of Burns in Children

Decreases in mortality from major thermal injury over the last 20 years have been due to advances in resuscitation, control of infection, support of the hypermetabolic response, and early closure of the burn wound. Of these advances in burn care, early wound closure has progressed the most in the last five years. The restoration of the protective functions of the skin is of primary importance to the recovery of the burn patient. Biologic dressings (pigskin, amnion, human skin allograft) when applied to fully debrided, relatively uncontaminated wounds have been shown to adhere to the wound surface, reduce the wound colony counts, limit fluid and protein loss, reduce pain, and increase the rate of epithelialization over that obtained with application of topical antimicrobial agents.