Childhood burns in Sulaimaniyah province, Iraqi Kurdistan: A prospective study of admissions and outpatients

Fire burns matter: A case-control study of severe accidental burns in pediatric patients

<b>Objective: </b>We aimed to identify factors associated with severe accidental burns in patients ≤12 years old.<br /> <b>Materials and methods: </b>We conducted a matched case-control study, in which we retrospectively reviewed the medical records of children treated in a single institution from 2014-2016. We classified the cases (patients with severe burns) and controls (patients with non-severe burns) according to the criteria of the American Burn Association. We used multivariate conditional logistic regression analysis to identify the relationship between the etiology of burns and their severity.<br /> <b>Results: </b>We reviewed 180 cases and 90 controls. The most common etiology of burns was boiling water in both cases (65.6%) and controls (83.3%). Most burns occurred inside the home (84.1%) and in the afternoon (37.4%). Multivariate analysis identified that severe burns were mainly due to exposure to fire (odds ratio [OR]: 3.22, 95% confidence interval [CI]: 1.53-6.81). Similarly, these patients were more likely to live in a rural area (OR: 2.96, 95% CI: 1.17-6.19).<br /> <b>Conclusions: </b>In pediatric patients ≤12 years of age severe accidental burns are more likely to be caused by fire compared to boiling water. Public health interventions should focus on populations located in rural areas.

Burns During Coronavirus Disease 19 Lockdown: a Multi-Center Retrospective Study in Israel

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.

Determination of factors affecting prevention of burns among children under five years old using PRECEDE model: A cross-sectional study in urban and rural populations

BACKGROUND

Burns are one of the most important childhood injuries that can be controlled and prevented. Mothers play an important role in preventing child burns. Health education and promotional theories facilitate a precise recognition of the behavioral factors in mothers that help preventing burn injury in their children. Burns in children under five years old and the factors in prevention of burn by their mothers were examined using PRECEDE Model. The study environment was rural and urban areas of Kermanshah, Iran.

METHODS

This cross-sectional study was conducted on 330 mothers in urban and rural areas of Kermanshah County in the west of Iran. The participants were randomly selected among mothers who had at least one child younger than five years old. Data was collected through interviewing the mothers using a valid and reliable questionnaire. The questionnaire included questions on demographic characteristics, PRECEDE Model, and history of burn. The data were analyzed using SPSS-16.

RESULTS

The mean age of the mothers in urban areas (29.33 ± 5.987) was higher than that of those in rural areas (28.77 ± 6.236). More than 90% of the mothers were housewives, both in urban and rural areas. The rate of a history of burn in rural children under the age of five (8.3%) was greater than that in urban children (5.2%). Most of the burn cases in urban areas were mild whereas those in rural areas were moderate. The majority of burn cases had happened at home in children 1-3 years' age range; this rate was higher in boys. The majority of burns cases had happened when the child was playing (urban: 64.3%, rural: 100%). In addition, liquids and hot objects were the main causes of the burns (urban: 78.5%, rural: 100%). Among the constructs of PRECEDE models in the urban areas, knowledge (P < 0.001), attitudes (P = 0.027), and environmental factors (P = 0.03) had a significant relationship with burn-preventive behaviors in mothers. In addition, in the rural areas, attitudes (P = 0.038) had a significant relationship with burn-preventive behaviors in mothers.

CONCLUSION

Burn was an important injury in the study population, especially in the rural areas. The PRECEDE model can help us to identify the factors in burn injuries in children and the preventive behaviors in mothers. The findings can be used to develop preventive interventional programs to better protect this vulnerable group in society.

Trends in Burn Injuries in Northern Israel During the COVID-19 Lockdown

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.

Comparison of comparable scald and contact burns in a porcine model: A preliminary report

Whether the depth and healing of scalds and contact burns are similar is controversial. Due to water's greater heat capacity, we hypothesized that when exposed to similar temperatures and durations of exposure, burns caused by hot water would be deeper than those caused by contact with hot metal. Forty standardized burns were created in two anesthetized female domestic pigs using a brass bar or circulating heated water. In one pig, the temperature was kept constant (95°C) while the duration of exposure varied (5, 10, 15 seconds) In the second pig, the exposure time was kept constant (10 seconds) while the temperature of exposure varied (70°C, 80°C, 98°C). Periodic punch biopsies were taken to determine burn depth immediately after injury, percentage burns reepithelialized within 21 days, and depth of scar at 28 days. The analysis was performed using analysis of variance. When the temperature was held constant, duration of exposure (5, 10, and 15 seconds) was associated with scar depth (2.1 vs 3.8 vs 5.0 mm, respectively, P = 0.001) but not with burn depth (2.0 vs 2.2 vs 2.3 mm, respectively, P = 0.10). When exposure duration was held constant, temperature (70°C, 80°C, 98°C) was associated with scar depth (0.6 vs 1.7 vs 3.6, P < 0.001) but not with burn depth (1.2 vs 1.5 vs 1.7 mm, respectively, P = 0.21). Burn depths were greater for scald than contact burns although not significantly greater. After controlling for temperature, the difference in scar depth between scalds and contact burns was statistically significant (marginal means 3.0 for contact burns, 4.3 for scalds, P = 0.008). We conclude that burns created in swine with circulating hot water result in deeper scars than those created by contact with a brass bar when controlling for temperature and duration of exposure.