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Lumsden E, Kimble R, McMillan C, Storey K, Ware RS, Griffin B. The feasibility of negative pressure wound therapy versus standard dressings in paediatric hand and foot burns protocol: a pilot, single-centre, randomised control trial. Pilot Feasibility Stud 2023; 9:90. [PMID: 37237316 DOI: 10.1186/s40814-023-01308-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION The goal of paediatric hand and foot burn management is hypertrophic scar and/or contracture prevention. The risk of scar formation may be minimised by integrating negative pressure wound therapy (NPWT) as an acute care adjunct as it decreases the time to re-epithelialisation. NPWT has known associated therapeutic burden; however, this burden is hypothesised to be outweighed by an increased likelihood of hypertrophic scar prevention. This study will assess the feasibility, acceptability and safety of NPWT in paediatric hand and foot burns with secondary outcomes of time to re-epithelialisation, pain, itch, cost and scar formation. METHODS AND ANALYSIS This is a single-site, pilot randomised control trial. Participants must be aged ≤ 16 years, otherwise well and managed within 24 h of sustaining either a hand or foot burn. Thirty participants will be randomised to either standard care (Mepitel®-a silicone wound interface contact dressing-and ACTICOAT™-a nanocrystalline silver-impregnated dressing) or standard care plus NPWT. Patients will be reviewed until 3 months post-burn wound re-epithelialisation, with measurements taken at dressing changes to assess primary and secondary outcomes. Surveys, randomisation and data storage will be done via online platforms and physical data storage collated at the Centre for Children's Health Research, Brisbane, Australia. Analysis will be performed using the Stata statistical software. ETHICS AND DISSEMINATION Queensland Health and Griffith University Human Research ethics approval including a site-specific assessment was obtained. The findings of this study will be disseminated through clinical meetings, conference presentations and peer reviewed journals. TRIAL REGISTRATION Registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12622000044729, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381890&isReview=true , registered 17/01/2022).
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Affiliation(s)
- Emma Lumsden
- Faculty of Health, Griffith University, Gold Coast Campus, Parklands Dr, Southport, QLD, 4222, Australia.
- Queensland Children's Hospital, Stanley St., South Brisbane, QLD, 4101, Australia.
- Centre for Children's Health Research, 62 Graham Street, South Brisbane, QLD, 4101, Australia.
| | - Roy Kimble
- Faculty of Health, Griffith University, Gold Coast Campus, Parklands Dr, Southport, QLD, 4222, Australia
- Queensland Children's Hospital, Stanley St., South Brisbane, QLD, 4101, Australia
- Centre for Children's Health Research, 62 Graham Street, South Brisbane, QLD, 4101, Australia
| | - Catherine McMillan
- Queensland Children's Hospital, Stanley St., South Brisbane, QLD, 4101, Australia
| | - Kristen Storey
- Queensland Children's Hospital, Stanley St., South Brisbane, QLD, 4101, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Parklands Dr, Southport, QLD, 4222, Australia
| | - Bronwyn Griffin
- Faculty of Health, Griffith University, Gold Coast Campus, Parklands Dr, Southport, QLD, 4222, Australia
- Centre for Children's Health Research, 62 Graham Street, South Brisbane, QLD, 4101, Australia
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Gurbuz K, Demir M. Comparison of work- and non-work-related lower extremity burn injuries: a retrospective analysis. J Burn Care Res 2022; 43:1337-1342. [PMID: 35290468 DOI: 10.1093/jbcr/irac034] [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: 01/09/2023]
Abstract
Lower extremity burn injuries are among the most affected anatomical regions in hospitalized burn patients. Our objective was to compare burn patients with work-related isolated lower extremity burn injuries (w-ILEBI) and patients with non-work-related isolated lower extremity burn injuries (nw-ILEBI). Sixty-four (15.7%) of 407 patients (16-92 years) were in the w-ILEBI cohort. The most extensive burn wounds were among patients in the fire-flame group with a median total body surface area percent (%TBSA) of 27.0 (IQR= 11.0-45.0%). While 50 (76.9%) patients in the electrical group had full-thickness burns, 99 (60%) of the cases in the scald group had superficial partial-thickness burns. Blood and wound sample cultures were positive in 42 (29.4%) patients in the fire-flame group. Approximately one-third of patients in the fire-flame/electrical group required escharotomy/fasciotomy procedures, only one (0.6%) case in the scald group, and none in the chemical/contact groups. Thirty-three (51%) of the patients in the electrical group underwent skin grafting, but fourteen (21.5%) required amputations. The highest mortality was detected in 27 (18.9%) patients in the fire-flame group. This study revealed several differences in clinical characteristics of isolated lower extremity burn injuries (ILEBI): burn mechanism and depth, %TBSA, infection, surgery requirements, laterality, and mortality. Within the scope of occupational health and safety measures, protective clothing and increased workplace and safety training for employers/employees should be implemented.
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Affiliation(s)
- Kayhan Gurbuz
- University of Health Sciences, Adana Faculty of Medicine, Department of General Surgery, Burn Center, Adana, Turkey
| | - Mete Demir
- University of Health Sciences, Adana Faculty of Medicine, Department of General Surgery, Burn Center, Adana, Turkey
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Choi YM, Nederveld C, Campbell K, Moulton S. A Soft Casting Technique for Managing Pediatric Hand and Foot Burns. J Burn Care Res 2020; 39:760-765. [PMID: 29635377 DOI: 10.1093/jbcr/irx039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Hand and foot burns in children are difficult to dress. The authors have developed a soft casting technique to manage burns to these areas. The aim of this study is to report the outcomes using weekly dressing changes with a soft casting technique to manage pediatric hand and foot burns in the outpatient setting. A retrospective chart review was performed on children with burns to the hands or feet, who underwent dressing changes with a soft casting technique at the Children's Hospital Colorado Burn Center. Soft casting was performed by placing antibiotic ointment-impregnated nonadherent gauze over the burn wound(s), wrapping the extremity using rolled gauze, applying soft cast pad, plaster, soft cast tape, and an elastic bandage. This was changed weekly. Two hundred ninety-eight children with hand burns had a mean age of 16.8 ± 2 months. Two hundred forty-eight children had partial thickness burn injuries (83%), 50 had full thickness burn injuries (17%), and the mean total body surface area (TBSA) was 1 ± 2.4%. The mean time to heal was 10.1 ± 1.7 days for all subjects. Sixty-six children with foot burns were identified with a mean age of 24 ± 2.6 months. Forty-six children had partial thickness injuries (70%), 20 had full thickness burn injuries (30%), and the mean TBSA was 2.3 ± 2.9%. The mean time to heal was 14.1 ± 2.2 days for all subjects. Weekly dressing changes using a soft casting technique are effective for the outpatient management of pediatric hand and foot burns. This method avoids costly inpatient hospital care, reduces the number of painful dressing changes, and allows children to heal in their own environment.
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Affiliation(s)
- Young Mee Choi
- Division of Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado.,Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado
| | - Cindy Nederveld
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado
| | - Kristen Campbell
- University of Colorado School of Public Health, Aurora, Colorado
| | - Steven Moulton
- Division of Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado.,Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado
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Sharaf A, Bautista M, Taylor L, Jivan S. Epidemiology of isolated adult lower limb burns over 15 years with a focus on preventable work-related injuries. Burns 2020; 46:1432-1435. [PMID: 31901405 DOI: 10.1016/j.burns.2019.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/11/2019] [Accepted: 12/22/2019] [Indexed: 10/25/2022]
Abstract
Our aim was to describe the epidemiology of isolated adult lower limb burns presenting to the Pinderfields Regional Burns Centre, Wakefield, United Kingdom between 2003 and 2018. Data was obtained using our local records of the international Burn Injury Database (iBID). 6059 patients were treated in our department during this period. 18.7% presented with isolated lower limb burns (n = 1133). 65.4% of patients were male (n = 741). Scald was the most common mechanism of injury. Work-related burns accounted for 23.4% of the injuries (n = 265). 36% of patients were admitted (n = 408), and 11.7% underwent surgical intervention (n = 133). Isolated lower limb burns are common in patients in the working age group. Work-related injuries are preventable. Targeted education to highlight the risks, reduce the incidence, and improve awareness of first aid measures are recommended.
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Affiliation(s)
- Amal Sharaf
- Department of Plastic Surgery and Burns, Pinderfields Hospital, Mid Yorkshire NHS Trust, United Kingdom.
| | - Melissa Bautista
- Department of Plastic Surgery and Burns, Pinderfields Hospital, Mid Yorkshire NHS Trust, United Kingdom
| | - Lauren Taylor
- Department of Plastic Surgery and Burns, Pinderfields Hospital, Mid Yorkshire NHS Trust, United Kingdom
| | - Sharmila Jivan
- Department of Plastic Surgery and Burns, Pinderfields Hospital, Mid Yorkshire NHS Trust, United Kingdom
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5
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Erdem MM, Koc G, Kismet K, Yasti C, Topuz S. Evaluation of spatio-temporal gait parameters and gait symmetry in diabetic polyneuropathic patients with burn injury: A pilot study. Burns 2019; 46:897-905. [PMID: 31843285 DOI: 10.1016/j.burns.2019.10.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 10/17/2019] [Accepted: 10/26/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The purpose of this study was to investigate the effects of burn injury on spatio-temporal gait parameters and gait symmetry in individuals with diabetic polyneuropathy (DPN)-related lower extremity burn injury. METHODS Demographic information and the physical examinations of the lower extremities of 14 patients with unilateral lower extremity burn injury due to DPN (DPNB) and 14 uninjured patients with DPN (DPN0) were recorded. The GAITRite computerized gait analysis system was used to evaluate the spatio-temporal parameters of gait. Symmetry Index (SI) was calculated to determine gait symmetry. The Mann Whitney U test was used to determine the demographical and clinical differences between the groups, the Wilcoxon's test was used to compare both sides of all the participants for all gait parameters and linear regression analysis was used to find the variables that affect gait parameters. RESULTS The groups were similar in terms of their demographic information except for age. Compared with the DPN0 group, DPNB group had increased extent of area with sensory loss and severity of DPN, decreased ankle joint range of motions and intrinsic foot muscles strength and they displayed lower gait speed, step length, stride length and swing percentage but their double support and stance percentage were increased. CONCLUSION This study results have shown that, spatio-temporal gait parameters of DPNB patients are different. These differences in spatiotemporal parameters are found on both sides, probably owing to the symmetric and bilateral sensory loss is superior to unilateral burn injury due to symmetrical and bilateral sensory loss. Gait analysis should be considered in order to reveal the changes in gait parameters and to improve appropriate healing process of patients with DPN-related lower extremity burn injury.
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Affiliation(s)
- Melek Merve Erdem
- Guneysu Vocational School of Physical Therapy and Rehabilitation, Department of Physical Therapy, Recep Tayyip Erdogan University, Rize, Turkey.
| | - Gonul Koc
- Department of Endocrinology and Metabolic Diseases, Ankara Education and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Kemal Kismet
- Department of General Surgery, Ankara Education and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Cınar Yasti
- Department of General Surgery, Numune Education and Research Hospital, Ankara, Turkey
| | - Semra Topuz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Momeni M, Sediegh-Marufi S, Safari-Faramani R, Akhoondinasab MR, Karimi H, Karimi AM. Lower Extremity Burns, Complications, and Outcome. J Burn Care Res 2019; 41:409-415. [DOI: 10.1093/jbcr/irz182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
We have encountered many burn cases with lower extremity burn with adverse outcome. The study was a retrospective cohort study in 2 years, mean (SD) of follow up was 12(7) months. All demographic data, cause burn, time, total burn surface area (TBSA), presence lower extremity burn and its burn surface area (BSA), foot burn, delay in treatment, smoking, infection, morbidity, co-morbid diseases, length of stay (LOS), amputation, mortality, and outcome were gathered from patients’ files. Statistical analysis was done with SPSS 21software. We had 14,215 burn patients, of them 995 were admitted according to criteria of ABA. Six hundred and ten (61.3%) were male and 358 (37%) female. Male to female ratio was 1.58:1. The mean age ± SD was 33.64 ±23.45. Mean (SD) of lower extremity BSA was 12.09 ± 9.18%. The patients who had 10 to 19% burn, had 3 times more risk of mortality than patients with 0 to 9% burn (P < .018). And those with 20 to 29% burn had 35 times more risk of mortality comparing to patients with 0 to 9% burn. The difference was significant too. (P < .000). Delay in treatment, presence of co-morbid diseases and diabetes would not do any increase in mortality. The sex, weight, cause of burn, diabetes, and delay in treatment have not any influence on the death risk. But age and lower extremity BSA have influence on the risk of death. According to statistical study: with every 1-year increase in age, death rate increased by 4% (P < .0001). With every 1% increase in lower extremity BSA, death rate increase by 9% (P < .0005) and with every 1 day increase in LOS, the death rate increase by 4%. Statistical study shows lower extremity burn, TBSA, age, and LOS have great influence on the outcome of these patients. Sex, weight, cause of burn, and delay in treatment have not affected the risk of mortality.
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Affiliation(s)
- Mahnoush Momeni
- General Surgery, Motahary Hospital, School of Medicine, Burn Research Center
| | | | - Roya Safari-Faramani
- Department of Epidemiology, Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Hamid Karimi
- Plastic and Reconstructive Surgery, Hazrat Fatemeh Hospital, School of Medicine, Burn Research Center
| | - Ali-Mohammad Karimi
- Surgery Department, Medical School, Iran University of Medical Sciences, Tehran, Iran
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Li L, Zhang J, Zhang Q, Zhang D, Xiang F, Jia J, Wei P, Zhang J, Hu J, Huang Y. High Glucose Suppresses Keratinocyte Migration Through the Inhibition of p38 MAPK/Autophagy Pathway. Front Physiol 2019; 10:24. [PMID: 30745880 PMCID: PMC6360165 DOI: 10.3389/fphys.2019.00024] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 01/10/2019] [Indexed: 12/13/2022] Open
Abstract
Wound healing is delayed frequently in patients with diabetes. Proper keratinocyte migration is an essential step during re-epithelialization. Impaired keratinocyte migration is a critical underlying factor responsible for the deficiency of diabetic wound healing, which is mainly attributed to the hyperglycemic state. However, the underlying mechanisms remain largely unknown. Previously, we demonstrated a marked activation of p38/mitogen-activated protein kinase (MAPK) pathway in the regenerated migrating epidermis, which in turn promoted keratinocyte migration. In the present study, we find that p38/MAPK pathway is downregulated and accompanied by inactivation of autophagy under high glucose (HG) environment. In addition, we demonstrate that inactivation of p38/MAPK and autophagy result in the inhibition of keratinocyte migration under HG environment, and the activating p38/MAPK by MKK6(Glu) overexpression rescues cell migration through an autophagy-dependent way. Moreover, diabetic wound epidermis shows a significant inhibition of p38/MAPK and autophagy. Targeting these dysfunctions may provide novel therapeutic approaches.
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Affiliation(s)
- Lingfei Li
- Institute of Burn Research, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Junhui Zhang
- Institute of Burn Research, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Qiong Zhang
- Institute of Burn Research, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Dongxia Zhang
- Institute of Burn Research, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Fei Xiang
- Institute of Burn Research, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jiezhi Jia
- Institute of Burn Research, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Ping Wei
- Endocrinology Department, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jiaping Zhang
- Department of Plastic Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jiongyu Hu
- State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,Endocrinology Department, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yuesheng Huang
- Institute of Burn Research, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.,State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
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Momeni M, Jafarian AA, Maroufi SS, Ranjpour F, Karimi H. Diabetes and foot burns. ANNALS OF BURNS AND FIRE DISASTERS 2018; 31:181-184. [PMID: 30863249 PMCID: PMC6367851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 06/20/2018] [Indexed: 06/09/2023]
Abstract
The incidence of diabetes and diabetic foot burns is increasing worldwide. In the present study, we surveyed frequency, morbidity and mortality of diabetic foot burn patients in our centre. The study was a cross-sectional survey with one-year follow up of our adult diabetic patients with lower extremity burns. Data on demographics, cause of burn, time from injury to hospital, TBSA, presence of neuropathy and diabetic foot, treatment plan for controlling blood sugar, smoking, infection, morbidity, co-morbid diseases, amputation and mortality were gathered from patient files. Statistical analysis was done with SPSS 21 software. A p value less than 0.05 was considered significant. Of the 34,300 burn patients seen in a year, 2096 were admitted according to ABA criteria. 47 patients had diabetic foot burn. Half of them had diabetic neuropathy. 48.9% had type I diabetes and 51.1% had type II. 70.2% were male, 29.8% were female. Mean +/- SD age was 58 +/- 14 years; 14 patients were smokers and 40 had co-morbid diseases. Hypertension frequency was 44%, ischemic heart disease 25%, CVA 8.5% and renal failure 6.4%. Half of the patients had uncontrolled blood sugar. Mean +/- SD delay in admission was 2.5±1.5 (days). Mean +/- SD TBSA was 2.4 +/- 1.4%. Mean +/- SD length of stay was 11.4±6.1 (days). 8.5% underwent amputation and there were no deaths. Diabetic foot burn patients delay seeking medical attention, have a longer length of stay, more complications and more amputations than other burn patients (compared with our previous study on burn patients). Prevention and training programs are highly needed to prevent foot burns.
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Affiliation(s)
- M. Momeni
- Hamid Karimi M.D., Professor of Plastic Surgery
Faculty of Medicine, Iran University of Medical SciencesP.O. Box 19395-4949, TehranIran.+98 9123179089+98 2188770048
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Ngu F, Patel B, McBride C. Epidemiology of isolated foot burns in children presenting to a Queensland paediatric burns centre- a two-year study in warmer climate. BURNS & TRAUMA 2017; 5:6. [PMID: 28261623 PMCID: PMC5330149 DOI: 10.1186/s41038-017-0070-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/07/2017] [Indexed: 11/30/2022]
Abstract
Background European studies of paediatric foot burns report scalds as the leading cause. Mechanisms of injury are different in warmer climates. We sought to characterize the mechanisms and outcomes of isolated foot burns in our population. Methods Retrospective review of a prospectively collected database of all children aged 0–15 years presenting to a Queensland paediatric burns centre over a 26-month period. Non-parametric analyses such as the Mann-Whitney U and Pearson Chi-square were used. Results There were 218 children with foot burns treated over a period of 2 years and 2 months of which 214 had complete records. There were significantly more boys than girls (n = 134, 62.6% cf. n = 80, 37.4%, p < 0.0001). The leading mechanism of injury was a contact burn accounting for 63.1% (n = 135) followed by scalds (23.8%, n = 51). Friction, flame and chemical burns were a minority but were significantly deeper (p = 0.03) and significantly more likely to require grafting (p = 0.04) and scar management (p < 0.0001) compared to contact and scald burns. Conclusions In our population, contact burns are the most common mechanism of injury causing burns to the feet. The leading aetiology is campfire burns, which account for one-third of all burns to the feet. Prevention campaigns targeted at this population could significantly reduce the burden of morbidity from these burns. Friction, flame and chemical burns constitute a minority of patients but are deeper and more likely to require skin grafting and scar management.
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Affiliation(s)
- Florence Ngu
- Pegg Leditschke Children's Burns Centre, Department of Paediatric Surgery, Lady Cilento Children's Hospital, 501 Stanley Street, South Brisbane, QLD 4101 Australia.,Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, University of Queensland, Queensland, Australia
| | - Bhaveshkumar Patel
- Pegg Leditschke Children's Burns Centre, Department of Paediatric Surgery, Lady Cilento Children's Hospital, 501 Stanley Street, South Brisbane, QLD 4101 Australia.,Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, University of Queensland, Queensland, Australia
| | - Craig McBride
- Pegg Leditschke Children's Burns Centre, Department of Paediatric Surgery, Lady Cilento Children's Hospital, 501 Stanley Street, South Brisbane, QLD 4101 Australia.,Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, University of Queensland, Queensland, Australia
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10
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Ngu F, Patel B, McBride C. Epidemiology of isolated foot burns in children presenting to a Queensland paediatric burns centre- a two-year study in warmer climate. BURNS & TRAUMA 2017. [PMID: 28261623 DOI: 10.1186/s41038-017-0070-3.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND European studies of paediatric foot burns report scalds as the leading cause. Mechanisms of injury are different in warmer climates. We sought to characterize the mechanisms and outcomes of isolated foot burns in our population. METHODS Retrospective review of a prospectively collected database of all children aged 0-15 years presenting to a Queensland paediatric burns centre over a 26-month period. Non-parametric analyses such as the Mann-Whitney U and Pearson Chi-square were used. RESULTS There were 218 children with foot burns treated over a period of 2 years and 2 months of which 214 had complete records. There were significantly more boys than girls (n = 134, 62.6% cf. n = 80, 37.4%, p < 0.0001). The leading mechanism of injury was a contact burn accounting for 63.1% (n = 135) followed by scalds (23.8%, n = 51). Friction, flame and chemical burns were a minority but were significantly deeper (p = 0.03) and significantly more likely to require grafting (p = 0.04) and scar management (p < 0.0001) compared to contact and scald burns. CONCLUSIONS In our population, contact burns are the most common mechanism of injury causing burns to the feet. The leading aetiology is campfire burns, which account for one-third of all burns to the feet. Prevention campaigns targeted at this population could significantly reduce the burden of morbidity from these burns. Friction, flame and chemical burns constitute a minority of patients but are deeper and more likely to require skin grafting and scar management.
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Affiliation(s)
- Florence Ngu
- Pegg Leditschke Children's Burns Centre, Department of Paediatric Surgery, Lady Cilento Children's Hospital, 501 Stanley Street, South Brisbane, QLD 4101 Australia.,Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, University of Queensland, Queensland, Australia
| | - Bhaveshkumar Patel
- Pegg Leditschke Children's Burns Centre, Department of Paediatric Surgery, Lady Cilento Children's Hospital, 501 Stanley Street, South Brisbane, QLD 4101 Australia.,Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, University of Queensland, Queensland, Australia
| | - Craig McBride
- Pegg Leditschke Children's Burns Centre, Department of Paediatric Surgery, Lady Cilento Children's Hospital, 501 Stanley Street, South Brisbane, QLD 4101 Australia.,Centre for Children's Burns and Trauma Research, Queensland Children's Medical Research Institute, University of Queensland, Queensland, Australia
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