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Demir Yiğit Y, Yiğit E, Yastı AÇ. A rare type of burn : Nylon burns. Turk J Surg 2022; 38:202-207. [PMID: 36483175 PMCID: PMC9714651 DOI: 10.47717/turkjsurg.2022.5373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/08/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES In this study, it was aimed to examine nylon burns in paediatric patients and compare the results with other causes of hot object contact burns. MATERIAL AND METHODS A 10-year retrospective study was conducted on 77 paediatric patients hospitalized for hot body burns at Gazi Yaşargil Training and Research Hospital Burn Center. RESULTS Of those patients with hot body burns, 72.7% (n= 56) were males and 27.3% (n= 21) were females. Male-to-female ratio was 2.67:1. Mean age of the patients was 4.79 (min= 1, max= 16) years. There were 42 patients who applied to our hospital on the day of their burn, while four patients applied one day after the burn, one patient applied two days after the burn, 13 patients applied three days after the burn and 17 patients applied five days after the burn. Most burns (79.3%) were third-degree burns, whereas 19.5% were seconddegree and 1.2% were fourth-degree burns. The most common causes of hot body burns were hot nylon and hot stoves, followed by hot ash and hot irons. The number of nylon burns was the highest in the summer and the highest number of hot stove burns occurred in the winter. Nylon burns were most common in the three to eight age group and then gradually decreased. The highest burn rate was observed in nylon burns. CONCLUSION The most common cause of all burns in the Turkish paediatric population is scalding. Although nylon burns are rare, they draw attention due to their higher burn degrees.
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Affiliation(s)
- Yasemin Demir Yiğit
- Clinic of Pediatrics, Gazi Yaşargil Training and Education Hospital, Diyarbakır, Türkiye
| | - Ebral Yiğit
- Burn Center, Gazi Yaşargil Training and Education Hospital, Diyarbakır, Türkiye
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Kruchevsky D, Levanon S, Givon A, Bodas M, Ramon Y, Ullmann Y, Zeltzer AA. Burns During Coronavirus Disease 19 Lockdown: a Multi-Center Retrospective Study in Israel. J Burn Care Res 2022; 44:75-80. [PMID: 35666996 PMCID: PMC9214151 DOI: 10.1093/jbcr/irac078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Indexed: 01/11/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic forced many countries into lockdowns to limit the spread of infection. Israel's containment measures included school closures, mobility restrictions, and workforce reductions. Our study evaluated the effect of COVID-19 on the occurrence and patterns of burn injuries. The study data was obtained via retrospective chart review of burn patients treated between March 15, 2020 and April 30, 2020, namely the period of strict national lockdown. This data was compared against data from paralleling periods between 2017 and 2019. A total of 686 patients were treated for burn injuries in the two study periods. Age group analysis revealed an increased ratio of pediatric patients aged 0-3 years during the lockdown (55.91% vs 40.79%, P = .002). In contrast, there were fewer patients presenting with burn injuries in the 7-16 and 17-29 age groups (9.66% vs 3.15%, P = .017; 16.46% vs 7.09%, P = .007, respectively). During both study periods, scald injuries were the most common burn etiology and burn injuries occurred most often at home. This predominance was further pronounced during the lockdown (71.65% vs 58.68%, P = .007; 90.55% vs 74.60%, P = .0001, respectively). The lockdown period underlined the danger faced by pediatric patients in their household environment. This danger was possibly compounded by an improper level of adult supervision as parents transitioned to remote work. These findings can educate us about factors that render burn injuries more likely not only during lockdowns, but also during regular times, thus shaping the development of burn prevention practices.
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Affiliation(s)
- Dani Kruchevsky
- Address correspondence to Dani Kruchevsky, MD, Rambam Health Care Campus, HaAliya HaShniya St 8, Haifa 31096, Israel.
| | - Shir Levanon
- Rappaport Faculty of Medicine, Technion Institute, Haifa, Israel
| | - Adi Givon
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel
| | - Moran Bodas
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel,School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Yitzchak Ramon
- Plastic & Reconstructive Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Yehuda Ullmann
- Plastic & Reconstructive Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Assaf A Zeltzer
- Plastic & Reconstructive Surgery Department, Rambam Health Care Campus, Haifa, Israel,Rappaport Faculty of Medicine, Technion Institute, Haifa, Israel
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GÜRBÜZ K, DEMİR M. Comparison of Patterns of Burn Severity and Clinical Characteristics of Pediatric Patients in a Referral Burn Center: Retrospective Analysis. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2022. [DOI: 10.17944/mkutfd.1066021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Murhula GB, Musole PB, Nama Kafupi B, Tshibwid A Zeng F, Garhalangwamuntu Mayeri D, Cikomola FG, Pompermaier L. Factors associated with outcomes after burn care: A retrospective study in Eastern Democratic Republic of Congo. J Burn Care Res 2021; 43:85-92. [PMID: 33773491 DOI: 10.1093/jbcr/irab051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE In low income countries, incidence of burns is high and severe burns are frequently managed at peripheral facilities. Outcome after burn care is poorly studied although it might help identify risk-group and improve treatment strategies. This study aimed to study factors associated with in-hospital outcomes in a burn cohort in the Democratic Republic of Congo. METHODS In this retrospective study we included burn patients admitted to the surgical department at the Hôpital Provincial Général de Référence de Bukavu between January 2013 and December 2018. Differences between groups were tested using χ2 test or Fisher's exact tests or Wilcoxon rank sum test, as appropriate. Multivariate logistic regression was used to analyze the effect of patients and of burn characteristics on in-hospital mortality, prolongated length of stay (=LOS≥25days) and occurrence of complications. RESULTS The study population consisted of 100 patients, mainly young male with rural origin, moderate sized but deep burns. Of them, 46 developed complications, 12 died. Median LOS was 25 days (IQR: 15-42). In-hospital death was independently associated with Total Burn Surface Area percentage "TBSA%" (OR=3.96; 95% CI=1.67-9.40) and Full thickness Burns "FTB" (10.68; 1.34-84.74); prolongated LOS with FTB (3.35; 1.07-10.49), and complication with rural origin (5.84; 1.51-22.53), TBSA% (3.96; 1.67-9.40), FTB (4.08; 1.19-14.00) and burns on multiple sites (4.38; 1.38-13.86). CONCLUSION In-hospital death was associated with TBSA% and FTB, prolongated LOS with FTB, and complication with burns characteristics and rural origin of the patients. Further studies are necessary to investigate the effect of provided burn care on outcomes.
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Affiliation(s)
| | - Patrick Bugeme Musole
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo
| | - Bienfait Nama Kafupi
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo
| | - Florent Tshibwid A Zeng
- Faculty of Medicine, Department of Surgery, University of Lubumbashi, Democratic Republic of Congo
| | | | - Fabrice Gulimwentuga Cikomola
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo.,Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of Congo
| | - Laura Pompermaier
- Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Kruchevsky D, Arraf M, Levanon S, Capucha T, Ramon Y, Ullmann Y. Trends in Burn Injuries in Northern Israel During the COVID-19 Lockdown. J Burn Care Res 2021; 42:135-140. [PMID: 32914186 PMCID: PMC7499677 DOI: 10.1093/jbcr/iraa154] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Coronavirus disease 2019 obliged many countries to apply lockdown policies to contain the spread of infection. The restrictions in Israel included limitations on movement, reduction of working capacity, and closure of the educational system. The present study focused on patients treated at a referral center for burns in northern Israel. Their goal was to investigate temporal variations in burn injuries during this period. Data were retrospectively extracted from the medical records of burn patients treated at our hospital between March 14, 2020 and April 20, 2020 (ie, the period of aggravated lockdown). Data from this period were compared with that from paralleling periods between 2017 and 2019. During the lockdown and paralleling periods, 178 patients were treated for burn injuries, of whom 44% were under 18. Although no restrictions were enforced during the virus outbreak period with regard to seeking medical care, we noticed a decrease in the number of patients admitted to the emergency room for all reasons. Of particular interest was a 66% decrease in the number of adult burn patients (P < .0001). Meanwhile, among the pediatric population, no significant decrease was observed. Nonetheless, subgroups with higher susceptibility to burn injuries included children aged 2 to 5 years (56.3% vs 23.8%, P = .016) and female patients from all pediatric age groups (57.1% vs 25%, P = .027). These findings may be explained by the presumably busier kitchen and dining areas during the lockdown. Overall, the study results can assist with building a stronger understanding of varying burn injuries and with developing educational and preventive strategies.
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Affiliation(s)
- Dani Kruchevsky
- Plastic and Reconstructive Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Maher Arraf
- Plastic and Reconstructive Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Shir Levanon
- Rappaport Faculty of Medicine, Technion Institute, Haifa, Israel
| | - Tal Capucha
- Rappaport Faculty of Medicine, Technion Institute, Haifa, Israel
| | - Yitzchak Ramon
- Plastic and Reconstructive Surgery Department, Rambam Health Care Campus, Haifa, Israel
| | - Yehuda Ullmann
- Plastic and Reconstructive Surgery Department, Rambam Health Care Campus, Haifa, Israel
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Diab J, Jacques M, Vandervord J, Holland AJA. A licence to grill: charcoal barbeque burns in the paediatric population. EUROPEAN JOURNAL OF PLASTIC SURGERY 2020. [DOI: 10.1007/s00238-020-01756-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Blankers K, Dankerlui N, van Loey N, Pursad M, Rode H, van Dijk M. Cross-cultural validation of the Itch Man Scale in pediatric burn survivors in a South African setting. Burns 2018; 45:725-731. [PMID: 30527642 DOI: 10.1016/j.burns.2018.09.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 07/18/2018] [Accepted: 09/28/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Pruritus or itch is a common symptom after burn injuries. The Itch Man Scale has been recommended to assess itch severity in children. The aim of this prospective observational study was to perform a cross-cultural validation of the Itch Man Scale by comparing it with the Numeric Rating Scale (NRS) and the Toronto Pediatric Itch Scale. METHOD At Red Cross War Memorial Children's Hospital in Cape Town, South Africa, parents of pediatric burn patients assessed their child's itch with the Itch Man Scale, NRS and Toronto Pediatric Itch Scale. Children from the age of 6years also rated the Itch Man Scale and NRS themselves. The Spearman rank order correlation between the different scales was calculated to determine construct validity. RESULTS Over a two-month period, 255 pediatric burn survivors with a median age of 2.3years (IQR 1.4-4.0) were included; 35 of them were aged 6-13years. Parents' Itch Man Scale ratings correlated significantly with parents' NRS ratings (0.82, 95% CI 0.78-0.86) and with the Toronto Pediatric Itch Scale of the parent (0.80, 95% CI 0.75-0.84). The correlation between the older children's Itch Man Scale rating and those of their parents was 0.66 (95% CI 0.37-0.83). CONCLUSION We concluded that the Itch Man Scale has promising validity and is a user-friendly tool to use in clinical practice to determine the itch intensity in children younger than 13years in a South African setting.
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Affiliation(s)
- Karlijn Blankers
- Department of Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Nick Dankerlui
- Department of Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Nancy van Loey
- Association of Dutch Burn Centers, Department Behavioral Research, Beverwijk, The Netherlands; Utrecht University, Department Clinical Psychology, Utrecht, The Netherlands
| | - Mereille Pursad
- Department of Occupational Therapy, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Heinz Rode
- Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Monique van Dijk
- Department of Paediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
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Azzam N, Oei JL, Adams S, Bajuk B, Hilder L, Mohamed AL, Wright IMR, Holland AJA. Influence of early childhood burns on school performance: an Australian population study. Arch Dis Child 2018; 103:444-451. [PMID: 29187346 DOI: 10.1136/archdischild-2017-313355] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 10/24/2017] [Accepted: 10/30/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To determine the influence of burn injuries on childhood performance in national standardised curriculum-based school tests. DESIGN Birth and health records of 977 children who were hospitalised with a burn injury between 2000 and 2006 in the state of New South Wales, Australia, were linked to performance scores in the National Assessment Program: Literacy and Numeracy test, a compulsory nationwide curriculum-based test (CBT) and compared with children who were not hospitalised for burns and who were matched for birth year, gender, gestation and socioeconomic status. MAIN OUTCOME MEASURES Test scores in years 3 (ages 8-9), 5 (ages 10-11) and 7 (ages 13-14) in numeracy, writing, reading, spelling, grammar and punctuation. RESULTS Mean age at first burn injury was 28 months (median: 20, range: 0-140). Children with burns were significantly more likely to have younger mothers (28.5 vs 29.6 years) (P<0.001), be indigenous (OR 2.5 (95% CI 2.1 to 3.1)) (P<0.001) and have siblings (OR 1.2 (95% CI 1.1 to 1.4)) (P<0.001). They were also less likely to meet national minimum standards in most domains of testing until year 5, even after adjustment for parental education levels, parental smoking, maternal age and indigenous status. Each 10% increase in total body surface area burnt was associated with a decrease in year 5 scores by 37.0% in numeracy and 71.9% in writing. CONCLUSIONS Most childhood burn injuries occur before the start of formal schooling. Children who are hospitalised for burns perform more poorly in CBT even after accounting for family and socioeconomic disadvantage. Rehabilitation of children with burn injuries must address school performance to decrease any long-term negative societal impact of burns.
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Affiliation(s)
- Nadin Azzam
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Ju-Lee Oei
- Royal Hospital for Women, Randwick, New South Wales, Australia.,University of New South Wales, School of Women's and Children's Health, Randick, New South Wales, Australia
| | - Susan Adams
- University of New South Wales, School of Women's and Children's Health, Randick, New South Wales, Australia.,Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Barbara Bajuk
- Pregnancy and Newborn Services Network, Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
| | - Lisa Hilder
- National Perinatal Epidemiology and Statistics Unit, University of New South Wales School of Women's and Children's Health and Centre for Big Data Research in Health, Randwick, New South Wales, Australia
| | - Abdel-Latif Mohamed
- Department of Neonatology, Centenary Hospital for Women and Children, Canberra, ACT, Australia
| | - Ian M R Wright
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Andrew J A Holland
- Department of Paediatric Surgery, Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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Johnson E, Maguire S, Hollén L, Nuttall D, Rea D, Kemp A. Agents, mechanisms and clinical features of non-scald burns in children: A prospective UK study. Burns 2017. [DOI: 10.1016/j.burns.2017.01.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children's Hospital in Cape Town, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070732. [PMID: 28684713 PMCID: PMC5551170 DOI: 10.3390/ijerph14070732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/15/2017] [Accepted: 07/03/2017] [Indexed: 11/25/2022]
Abstract
Referral guidelines for burn care are meant to assist in decision-making as regards patient transfer and admissions to specialized units. Little is known, however, concerning how closely they are followed and whether they are linked to patient care. This is the object of the current study, focused on the paediatric burns centre of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa. All patients admitted to the centre during the winters of 2011–2015 (n = 1165) were included. The patient files were scrutinized to clarify whether the referral criteria in place were identified (seven in total) and to compile data on patient and injury characteristics. A case was defined as adherent to the criteria when at least one criterion was fulfilled and adherence was expressed as a percentage with 95% confidence intervals, for all years aggregated as well as by year and by patient or injury characteristics. The association between adherence to any individual criterion and hospital care (surgery or longer length of stay) was measured using logistic regressions. The overall adherence was 93.4% (100% among children under 2 years of age and 86% among the others) and it did not vary remarkably over time. The two criteria of “injury sustained at a specific anatomical site” (85.2%) and “young age” (51.9%) were those most often identified. Children aged 2 years or older were more likely to undergo surgery or to stay longer than those of young age (although a referral criterion) and so were those with higher injury severity (a referral criterion). In this specialized paediatric burns centre, children are admitted mainly according to the guidelines. However, given the high prevalence of paediatric burns in the region and the limited resources at the burns centre, adherence to the guidelines need to be further studied at all healthcare levels in the province.
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Martin NA, Falder S. A review of the evidence for threshold of burn injury. Burns 2017; 43:1624-1639. [PMID: 28536038 DOI: 10.1016/j.burns.2017.04.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/05/2017] [Accepted: 04/02/2017] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Burn injury is common and depth is one measure of severity. Although the depth of burn injury is determined by many factors, the relationship between the temperature of the injurious agent and exposure duration, known as the time-temperature relationship, is widely accepted as one of the cornerstones of burn research. Moritz and Henriques first proposed this relationship in 1947 and their seminal work has been cited extensively. However, over the years, readers have misinterpreted their findings and incorporated misleading information about the time-temperature relationship into a wide range of industrial standards, burn prevention literature and medicolegal opinion. AIM The purpose of this paper is to present a critical review of the evidence that relates temperature and time to cell death and the depth of burn injury. These concepts are used by researchers, burn prevention strategists, burn care teams and child protection professionals involved in ascertaining how the mechanism of burning relates to the injury pattern and whether the injury is consistent with the history. REVIEW METHODS This review explores the robustness of the currently available evidence. The paper summarises the research from burn damage experimental work as well as bioheat transfer models and discusses the merits and limitations of these approaches. REVIEW FINDINGS There is broad agreement between in vitro and in vivo studies for superficial burns. There is clear evidence that the perception of pain in adult human skin occurs just above 43°C. When the basal layer of the epidermis reaches 44°C, burn injury occurs. For superficial dermal burns, the rate of tissue damage increases logarithmically with a linear increase in temperature. Beyond 70°C, rate of damage is so rapid that interpretation can be difficult. Depth of injury is also influenced by skin thickness, blood flow and cooling after injury. There is less clinical evidence for a time-temperature relationship for deep or subdermal burns. Bioheat transfer models are useful in research and becoming increasingly sophisticated but currently have limited practical use. Time-temperature relationships have not been established for burns in children's skin, although standards for domestic hot water suggest that the maximum temperature should be revised downward by 3-4°C to provide adequate burn protection for children. CONCLUSION Time-temperature relationships established for pain and superficial dermal burns in adult human skin have an extensive experimental modeling basis and reasonable clinical validation. However, time-temperature relationships for subdermal burns, full thickness burns and burn injury in children have limited clinical validation, being extrapolated from other data, and should be used with caution, particularly if presented during expert evidence.
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Affiliation(s)
- N A Martin
- St. Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex CM1 7ET, UK.
| | - S Falder
- Department of Burns and Plastic Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool L12 2AP, UK.
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Rybarczyk MM, Schafer JM, Elm CM, Sarvepalli S, Vaswani PA, Balhara KS, Carlson LC, Jacquet GA. A systematic review of burn injuries in low- and middle-income countries: Epidemiology in the WHO-defined African Region. Afr J Emerg Med 2017; 7:30-37. [PMID: 30456103 PMCID: PMC6234151 DOI: 10.1016/j.afjem.2017.01.006] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/03/2016] [Accepted: 01/10/2017] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION According to the World Health Organization (WHO), burns result in the loss of approximately 18 million disability adjusted life years (DALYs) and more than 250,000 deaths each year, more than 90% of which are in low- and middle-income countries (LMICs). The epidemiology of these injuries, especially in the WHO-defined African Region, has yet to be adequately defined. METHODS We performed a systematic review of the literature regarding the epidemiology of thermal, chemical, and electrical burns in the WHO-defined African Region. All articles indexed in PubMed, EMBASE, Web of Science, Global Health, and the Cochrane Library databases as of October 2015 were included. RESULTS The search resulted in 12,568 potential abstracts. Through multiple rounds of screening using criteria determined a priori, 81 manuscripts with hospital-based epidemiology as well as eleven manuscripts that included population-based epidemiology were identified. Although the studies varied in methodology, several trends were noted: young children appear to be at most risk; most individuals were burned at home; and hot liquids and flame are the most common aetiologies. DISCUSSION While more population-based research is essential to identifying specific risk factors for targeted prevention strategies, our review identifies consistent trends for initial efforts at eliminating these often devastating and avoidable injuries.
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Affiliation(s)
- Megan M. Rybarczyk
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, United States
| | - Jesse M. Schafer
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Courtney M. Elm
- Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, United States
| | - Shashank Sarvepalli
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States
| | - Pavan A. Vaswani
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States
| | - Kamna S. Balhara
- Department of Emergency Medicine, The Johns Hopkins Hospital, Baltimore, MD, United States
| | - Lucas C. Carlson
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, United States
| | - Gabrielle A. Jacquet
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, United States
- Boston University School of Medicine, Boston, MA, United States
- Boston University Center for Global Health and Development, Boston, MA, United States
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Battle CE, Evans V, James K, Guy K, Whitley J, Evans PA. Epidemiology of burns and scalds in children presenting to the emergency department of a regional burns unit: a 7-year retrospective study. BURNS & TRAUMA 2016; 4:19. [PMID: 27574688 PMCID: PMC4964307 DOI: 10.1186/s41038-016-0047-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 04/28/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Variation in the incidence and mechanism of thermal injury has been reported in different age groups in children. The aim of this study was to report the incidence, mechanisms, and environmental factors of all burns presentations to the emergency department (ED) of a regional burns centre over a 7-year period. METHODS A retrospective, chart review study of all burns presentations to the ED of a regional burns centre in South Wales was conducted. All children recorded as having sustained a burn or scald, aged less than 16 years were included in the analysis. Subjects' demographics were analysed using descriptive statistics, and comparisons were made between patients aged less than 5 and patients aged 5-16 using chi-square test and Mann-Whitney U test. RESULTS A total of 1387 cases were included in the final analysis. Scalds were the most common thermal injury with 569 (41.0 %) reported, followed by contact burns in 563 (40.6 %) patients. The patients requiring hospitalisation were significantly younger (2 vs 3 years; p < 0.001) and had a higher rate of non-accidental injury (10 vs 4; p < 0.001). The most commonly injured site in both age groups was a hand or digit. CONCLUSIONS Scalds and contact burns were the most commonly reported thermal injury in children aged less than 16. Common mechanisms were hot beverages, hobs and hair straighteners, highlighting further burn prevention strategies are needed and good-quality prospective studies that investigate the effectiveness of such strategies.
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Affiliation(s)
- Ceri Elisabeth Battle
- Department of Emergency Medicine, NISCHR Haemostasis Biomedical Research Unit, Morriston Hospital, Swansea, UK ; Department of Physiotherapy, Morriston Hospital, Swansea, UK
| | - Vanessa Evans
- Department of Emergency Medicine, NISCHR Haemostasis Biomedical Research Unit, Morriston Hospital, Swansea, UK
| | - Karen James
- Department of Physiotherapy, Morriston Hospital, Swansea, UK
| | - Katherine Guy
- Department of Emergency Medicine, Morriston Hospital, Swansea, Wales SA6 6NL UK
| | - Janet Whitley
- Department of Emergency Medicine, NISCHR Haemostasis Biomedical Research Unit, Morriston Hospital, Swansea, UK
| | - Phillip Adrian Evans
- Department of Emergency Medicine, NISCHR Haemostasis Biomedical Research Unit, Morriston Hospital, Swansea, UK
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Epidemiologic characteristics of death by burn injury from 2000 to 2009 in Colombia, South America: a population-based study. BURNS & TRAUMA 2016; 4:8. [PMID: 27574678 PMCID: PMC4963989 DOI: 10.1186/s41038-016-0033-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/09/2016] [Indexed: 11/16/2022]
Abstract
Background Burns are one of the most severe traumas that an individual can suffer. The World Health Organization (WHO) affirms that injuries related to burns are a global public health problem mainly in low- and middle-income countries. The first step towards reducing any preventable injury is based on accurate information. In Colombia, the basic epidemiological characteristics of burn injuries are unknown. The objectives were establishing the causes, high-risk populations, mortality rate, and tendencies of burn deaths. Methods Observational, analytical, population-based study based on official death certificate occurred between 2000 and 2009. All codes of the International Classification of Diseases-10th Revision (ICD-10) related to burns were included. The mortality rates were standardized using the WHO world average age weights 2000–2025. To determine the tendency, an average annual percent change (AACP) was calculated. Results A total of 5448 deaths due to burns were identified; 78.4 % were men. The crude and adjusted burn mortality rate was 1.270 and 1.302 per 100,000, respectively. The AACP was −5.25 %. Electrical injury caused the greatest number of deaths (49.5 %), followed by fire and lightning injuries. A total of 1197 (22.1 %) children were under 15 years old. The causes of deaths were different among age groups. 59.4 % deaths occurred outside health institutions. Conclusions This study is a first step in identifying the main causes of death and groups with higher mortality rates. Electricity is the main cause of deaths due to burn injury. Further research is required in order to generate awareness among government and community for reducing the number of injuries and burn deaths in our country.
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Nthumba PM. Burns in sub-Saharan Africa: A review. Burns 2015; 42:258-66. [PMID: 25981292 DOI: 10.1016/j.burns.2015.04.006] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 02/25/2015] [Accepted: 04/17/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Burns are important preventable causes of morbidity and mortality, with a disproportionate incidence in sub-Saharan Africa. The management of these injuries in sub-Saharan Africa is a challenge because of multiple other competing problems such as infectious diseases (HIV/AIDS, tuberculosis and malaria), terrorist acts and political instability. There is little investment in preventive measures, pre-hospital, in-hospital and post-discharge care of burns, resulting in high numbers of burns, high morbidity and mortality. Lack of data that can be used in legislation and policy formulation is a major hindrance in highlighting the problem of burns in this sub-region. METHODS An online search of publications on burns from sub-Saharan countries was performed. RESULTS A total of 54 publications with 32,862 patients from 14 countries qualified for inclusion in the study. The average age was 15.3 years. Children aged 10 years and below represented over 80% of the burn patient population. Males constituted 55% of those who suffered burns. Scalds were the commonest cause of thermal injuries, accounting for 59% of all burns, while flame burns accounted for 33%. The burn mortality averaged 17%, or the death of one of every five burn victims. CONCLUSIONS These statistics indicate the need for an urgent review of burn policies and related legislation across the sub-Saharan region to help reduce burns, and provide a safe environment for children.
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Laitakari E, Koljonen V, Rintala R, Pyörälä S, Gissler M. Incidence and risk factors of burn injuries among infants, Finland 1990-2010. J Pediatr Surg 2015; 50:608-12. [PMID: 25840072 DOI: 10.1016/j.jpedsurg.2014.05.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 04/29/2014] [Accepted: 05/25/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND Our aim was to study the incidence, mechanisms, treatment, and risk factors of burn injuries in infants younger than 1 year. METHODS Data on burn-injured infants during 1990-2011 in Finland came from the National Hospital Discharge Register (NHDR). Information on birth and maternal-related factors came from the Finnish Medical Birth Register, and data on fatal injuries from the Cause of Death Register of Finland. RESULTS This study included 1842 children, female to male 1:1.5. The annual overall incidence of inhospital and outpatient admissions increased during the study period (p<0.05). Major risk factors were male gender, parity, and the mother's socioeconomic status and young age. The most common causes were scalds and contact burns. Severity of the injury increased along with increasing age, and children aged 9-12 months had the highest prevalence of surgical treatment. CONCLUSIONS Burn injury incidence in children under 1 year has increased during recent decades in Finland. First-born 9- to 12-month-old boys of young mothers of low socioeconomic status are at higher risk of burn injuries. Preventative work needs strengthening to reduce infant burn injuries.
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Affiliation(s)
- Elina Laitakari
- Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland.
| | - Virve Koljonen
- Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland, Institute of Clinical Medicine, Helsinki University, Helsinki, Finland
| | - Risto Rintala
- Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - Sari Pyörälä
- Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - Mika Gissler
- National Institute for Health and Welfare, Helsinki, Finland; Nordic School of Public Health, Gothenburg, Sweden
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Verey F, Lyttle MD, Lawson Z, Greenwood R, Young A. When do children get burnt? Burns 2014; 40:1322-8. [DOI: 10.1016/j.burns.2014.01.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 01/09/2014] [Accepted: 01/10/2014] [Indexed: 11/30/2022]
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Laitakari E, Koljonen V, Pyörälä S, Rintala R. Outpatient treated burns in infants younger than 1 year in Helsinki during 2005–2009. Burns 2014; 40:489-94. [DOI: 10.1016/j.burns.2013.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 06/02/2013] [Accepted: 08/02/2013] [Indexed: 10/26/2022]
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Abstract
OBJECTIVE To describe the characteristics of childhood burns and scalds, mechanisms and agents to inform prevention. METHODS Prospective multicentred cross-sectional study of children (<16 years) with unintentional burns/scalds from five Emergency Departments (ED), a burns assessment unit and three regional children's Burns Units. DATA COLLECTED site, severity, distribution of the burn/scald, age, motor development of the child, agent and mechanism of the injury. Comparative analysis for children <5 and 5-16 years. RESULTS Of 1215 children, 58% (709) had scalds, 32% (390) contact burns and 116 burns from other causes, 17.6% (214/1215) were admitted to hospital and the remaining treated in ED or burns assessment centre. 72% (878) were <5 years, peak prevalence in 1-year-olds. Commonest scald agent (<5 years) was a cup/mug of hot beverage 55% (305/554), and commonest mechanism was a pull-down injury 48% (66/554). In 5-16-year-olds, scalds were from hot water 50% (78/155) and spill injuries 76% (118/155). Scalds affected the front of the body in 96% (680/709): predominantly to the face, arms and upper trunk in <5-year-olds, older children had scalds to the lower trunk, legs and hands. Contact burns (<5 years) were from touching 81% (224/277) hot items in the home, predominant agents: hair straighteners or irons 42% (117/277), oven hobs 27% (76/277), 5-16-year-olds sustained more outdoor injuries 46% (52/113). 67% (262/390) of all contact burns affected the hands. CONCLUSIONS Scalds to infants and toddlers who pull hot beverages over themselves or sustain burns from touching irons, hair straighteners or oven hobs are a high priority for targeted prevention.
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Affiliation(s)
- A M Kemp
- Early Years Research Programme, Institute of Primary Care and Public Health, Cardiff University, , Heath Park, Cardiff, UK
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Gevaart-Durkin A, Swart D, Chowdhury Z. A study of energy-related injuries from hospital admissions among children and adults in South Africa. Burns 2014; 40:1209-18. [PMID: 24480370 DOI: 10.1016/j.burns.2013.12.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 12/16/2013] [Accepted: 12/17/2013] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Burn and ingestion injuries are common in developing countries because of poor access to safe energy sources, crowded living conditions, and insufficient knowledge of potential risks. The purpose of this study is to understand the scope of burn and ingestion injuries due to various energy source usages in South Africa. METHODS Patients at 16 regional hospitals throughout South Africa presenting with an energy-related injury between 2006 and 2012 were interviewed to obtain demographics and injury characteristics. RESULTS A total of 12,443 patients were included in this study. Children aged 1-2 years predominantly experienced burn and ingestion injuries (21%). Liquid burns (30%) were more common than flame burns (14%). Chi-squared tests show that age was significantly related to degree of burn, type of burn, and severity of burn (p<0.001). Non-intentional injuries (45%) were more frequent than self-inflicted or assault injuries. Temporal and seasonal injury trends reflect usage patterns. Burn injuries result in longer hospital length of stay than ingestion injuries. CONCLUSION Non-intentional liquid burns and ingestions to infants and babies were most common in this study, with many injuries also occurring among young adults. It is advised that interventions targeting low-income communities be conducted to increase awareness of burn and ingestion injuries.
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Affiliation(s)
- A Gevaart-Durkin
- Graduate School of Public Health, San Diego State University, San Diego, CA, United States.
| | - D Swart
- Research and Education, Paraffin Safety Association of Southern Africa, Cape Town, South Africa
| | - Z Chowdhury
- Graduate School of Public Health, San Diego State University, San Diego, CA, United States
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Abstract
Approximately 2457 research articles were published with burns in the title, abstract, and/or keyword in 2012. This number continues to rise through the years; this article reviews those selected by the Editor of one of the major journals in the field (Burns) and his colleague that are most likely to have the greatest likelihood of affecting burn care treatment and understanding. As done previously, articles were found and divided into these topic areas: epidemiology of injury and burn prevention, wound and scar characterization, acute care and critical care, inhalation injury, infection, psychological considerations, pain and itching management, rehabilitation, long-term outcomes, and burn reconstruction. Each selected article is mentioned briefly with comment from the authors; readers are referred to the full papers for further details.
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Affiliation(s)
- Steven E Wolf
- Division of Burn, Trauma, and Critical Care, Department of Surgery, University of Texas - Southwestern Medical Center, Dallas, TX 75390-9158, United States.
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Epidemiology of paediatric burns in Lithuania: focus on a vulnerable population exposed to the risk of scalds at home without hot tap water supply. Burns 2013; 40:506-10. [PMID: 24129159 DOI: 10.1016/j.burns.2013.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 07/26/2013] [Accepted: 07/26/2013] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To describe the epidemiology of paediatric burns in Lithuania, identify the trends of burn occurrence, the vulnerable population and aetiology. METHODS This study was based on all inclusive national information obtained from the National Health Insurance database for the period of 2001-2010. Information on the burns aetiology was collected in the Hospital of Lithuanian University of Heath Sciences Kauno Klinikos. FINDINGS 7146 children in the age group of 0-14 were hospitalized in Lithuania and constituted 44% of all admissions due to burns. The incidence among boys was 149.8 and among girls 99.9 per 100,000. The highest risk of burns was observed from 11 to 15 months of age. Scalding in 0-1 years age group composed 96% of all burns in this age group. CONCLUSION Children younger than 2 years of age are a vulnerable population of burns in Lithuania. Scalding was main cause of their burns. The aetiological subgroups of scalding were scalding with hot drinks/food and scalding with hot water meant for household. The major part of scalding with hot drinks was due to scalding with parents' drinks. Scalding with hot water meant for household is associated with the lack of hot water supply.
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