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Characteristics and trends of pediatric firepit Burns: insights for prevention and safety

World Journal of Pediatric Surgery 2024年第1期7卷 54-58页

作者： Maria Fazal Charbel Chidiac Raheel Ahmad Oussama Issa Erica Hodgman Alejandro V Garcia Johns Hopkins School of Medicine BaltimoreMarylandUSA Department of Surgery Division of Pediatric SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA Division of the Biological Sciences University of ChicagoChicagoIlinoisUSA School of Medicine American University of BeirutBeirutLebanon

Introduction As fire pits grow in popularity,so do the associated burn injuries.Our study examines pediatric fire pit Burns characteristics to raise awareness and promote safety precautions.Methods We conducted a retrospective review of pediatric patients(Burns at a tertiary care hospital from 2016 to 2021.Results Eighty-four patients were identified,of whom 70.2%were male,with a median age of 62 months.The median percent total body surface area burned was 2%(interquartile range(IQR)=1-4).Thirty-five(41.7%)patients were admitted and 7(8.3%)underwent grafting.Neck and trunk Burns had the highest grafting rates(66%and 33%,respectively).The hands(41.7%)and the lower extremities(27.4%)were the most frequently burned body areas.The leading causes of Burns were ashes/hot coals(34.5%),flames(31.0%),and direct contact(25.0%),often resulting from falling into the fire(59.5%)or running or playing in activities near it(26.2%).Thirty-five(41.7%)were admitted for inpatient management,while 49(58.3%)were treated as outpatient.Eleven(13.2%)underwent at least one reconstructive surgery,7(8.4%)had at least one rehabilitation visit,and 65(77.4%)had follow-up clinic visits.The median length of stay was 2 days(IQR=1.0-3.5).The peak months for Burns were from August through October(n=40,46.0%),with an increase observed from 10 cases in 2016to 20 cases in 2020.Conclusions Given the significant proportion of firepit Burns resulting from unsafe fire behaviors,it is crucial that caretakers are aware of proper firepit safety precautions.Level ofevidence Il.

关键词： Burns admitted prevention

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Curative effect and possible mechanism of taurine on early corneal alkali Burns

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Chinese Medical Journal 2022年第6期135卷 744-746页

作者： Yuan Tan Min Zhang Yingzhe Pan Lixia Xie Department of Ophthalmology Xiangyang No.1 People's HospitalHubei University of MedicineXiangyangHubei 441000China

To the Editor:Corneal alkali Burns(CABs)have been a difficult problem in clinical treatment for a long time.In severe cases,blindness occurs;hence,research on the repair mechanism underlying corneal injury is particularly important to identify potential therapeutic targets.Alkali-induced corneal injuries often trigger aggressive aseptic inflammatory responses,which are key to autoimmune responses.[1]However,Nod-like receptor protein 3(NLRP3)inflammasomes play an important role in aseptic inflammation.[2]Under stimuli,such as infection or stress,the activated NLRP3 inflammasome not only processes procaspase-1 into mature caspase-1 but also further promotes the maturation and release of interleukin(IL)-1βand IL-18.[3]Taurine(Tau)is widely distributed in ocular structures and is an immune regulator.Tau can maintain the stability of the corneal epithelium and improve the survival rate of corneal epithelial cells through antioxidant effects.[4]The purpose of this study was to investigate the effect of Tau eye drops on CAB and elucidate the mechanism underlying corneal inflammatory responses.

关键词： corneal Burns injuries

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A 94-year-old patient with severe Burns: a case report

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World Journal of Emergency Medicine 2023年第3期14卷 255-256页

作者： Ying Ren Qun-fei Yu Fei Lu Yao-jing Ma Xiu-qin Feng Nursing Department the Second Affi liated Hospital of Zhejiang University School of MedicineHangzhou 310009China

Burns often happen unexpectedly and have the potential to cause death,lifelong disfigurement and dysfunction.[1]According to the depth of the burn wound and extent of affected burned body surface area,Burns are classifi ed as mild or severe.Mild Burns usually refer to Burns that encompass less than 10%of the total body surface area(TBSA),mainly superficial Burns.Severe Burns are defined as TBSA>10%in elderly patients,TBSA>20%in adults,and TBSA>30%in children.[2]Burn injuries,particularly severe Burns,are accompanied by an immune and inflammatory response,metabolic changes and distributive shock that can be challenging to manage and can lead to multiple organ failure.[3]Therefore,burn care providers face many challenges,including acute and critical care management,long-term care,and rehabilitation.Here,we report a 94-year-old patient with severe Burns who recovered well and was discharged from the hospital in a wheelchair.

关键词： Burns injuries superficial

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Systemic treatment for severe concentrated sulfuric acid Burns in an adult male at high altitude:A case report

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World Journal of Clinical Cases 2020年第7期8卷 1337-1342页

作者： Ruo-Mei Zhao Yi Li Sheng-Wu Chao Hong-Jin Wang The Graduate School Of Qinghai University Xining 810016Qinghai ProvinceChina Department of Burns and plastic Surgery Qinghai University Affiliated Hospital of Qinghai UniversityXining 810016Qinghai ProvinceChina

BACKGROUND The aim of this study was to report a case of a patient who suffered from severe concentrated sulfuric acid Burns while working at high altitude.This patient recovered after systemic treatment.We also provide a literature review for a better understanding of the disease.CASE SUMMARY A 30-year-old male,who was working in a local chemical plant in Xining at an altitude of 2261 m,suffered from 85%Burns(Ⅲ°70%,deep Ⅱ°15%)after a tank containing 80%concentration of sulfuric acid exploded.The patient immediately received a series of first aid treatments,as well as rigorous wound managements after admission,which included protection for the whole body and organs,prevention and treatment of eye Burns,and the appropriate oxygen therapy.After 65 d of treatment,the burn wounds had completely healed,and the patient was transferred to another specialized hospital for further eye treatment.The first aid before admission and the emergency treatment of wounds following admission were appropriate.No severe complications of sepsis,severe renal insufficiency,septic costal chondritis,corneal perforation or other Burns occurred during the treatment.CONCLUSION The main causes of concentrated sulfuric acid Burns consisted of accidental Burns at work,accidents in the outside,factitious injuries and improper laboratory operations.The clinical manifestations were mostly deep Ⅱ°and Ⅲ°Burns,with a formation of brown-black,leather-like eschar on the wound surface and locally embolized dendrite-like vessels.The clear cause of the injury and typical clinical manifestations in this case made it easy to diagnosis.However,adult cases with severe concentrated sulfuric acid Burns in high altitude areas are rare,so the successful treatment of this case is of great significance.

关键词： High altitude area Concentrated sulfuric acid Burns Extensive burn Case report

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Epidemiology of pediatric Burns and future prevention strategies—a study of 475 patients from a high-volume burn center in North India

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Burns & Trauma 2017年第1期5卷 50-57页

作者： Amol Dhopte V.K.Tiwari Pankaj Patel Rahul Bamal Department of Burns Plastic&Maxillofacial SurgeryVMMC&Safdarjung HospitalNew DelhiIndia Present Address:Department of Burns&Plastic Surgery PGIMER&RML HospitalNew DelhiIndia

Background: Pediatric Burns have a long-term social impact. This is more apparent in a developing country such as India, where their incidence and morbidity are high. The aim of this study was to provide recent prospective epidemiological data on pediatric Burns in India and to suggest future preventive strategies. Methods: Children up to 18 years old admitted to the Department of Burns, Plastic&Maxillofacial Surgery, VMMC&Safdarjung Hospital, New Delhi, between January and December 2014 were included in the study. Data regarding age, sex, etiology, total body surface area (TBSA), circumstances of injury, and clinical assessment were collected. The Mann-Whitney test or Kruskal-Wallis test or ANOVA was used to compare involved TBSA among various cohort groups accordingly. Univariate and multivariate linear regression analyses were used to determine the predictors of TBSA. Results: There were a total of 475 patients involved in the study, including seven suicidal Burns, all of whom were females with a mean age greater than the cohort average. Age, type of Burns, mode of injury, presence or absence of inhalation injury, gender, and time of year (quarter) for admission were found to independently affect the TBSA involved. Electrical Burns also formed an important number of presenting burn patients, mainly involving teenagers. Several societal issues have come forth, e.g., child marriage, child labor, and likely psychological problems among female children as suggested by a high incidence of suicidal Burns. Conclusions: This study also highlights several issues such as overcrowding, lack of awareness, dangerous cooking practices, and improper use of kerosene oil. There is an emergent need to recognize the problems, formulate strategies, spread awareness, and ban or replace hazardous substances responsible for most burn accidents.

关键词： Epidemiology Pediatric Burns India Suicidal Burns Burn prevention

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Epidemiology of isolated foot Burns in children presenting to a Queensland paediatric Burns centre—a two-year study in warmer climate

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Burns & Trauma 2017年第1期5卷 58-63页

作者： Florence Ngu Bhaveshkumar Patel Craig McBride Pegg Leditschke Children’s Burns Centre Department of Paediatric SurgeryLady Cilento Children’s Hospital501 Stanley StreetSouth Brisbane QLD 4101Australia Centre for Children’s Burns and Trauma Research Queensland Children’s Medical Research InstituteUniversity of QueenslandQueenslandAustralia

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%, pBurns were a minority but were significantly deeper (p=0.03) and significantly more likely to require grafting (p=0.04) and scar management (pBurns. 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.

关键词： Epidemiology Foot Burns Paediatric Scald Australia Campfire

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Decreasing incidence of cutaneous chemical Burns in a resource limited burn centre: is this a positive effect of modernization?

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Burns & Trauma 2017年第1期5卷 64-67页

作者： R.E.E.Nnabuko C.P.Okoye I.S.Ogbonnaya Egi Isiwele Burns and Plastic Department National Orthopaedic HospitalPMB 01294 EnuguNigeria Department of Surgery University of Calabar Teaching HospitalCalabarNigeria

Background: Burns present a devastating injury to patients. Burns caused by chemical agents, present a worse scenario. In a resource limited country like Nigeria, readily available sources of these corrosive agents are mainly from lead-acid battery vendors and to some extent local small scale soap manufacturers who use caustic soda. We hypothesized that with the reduction in small scale soap manufacturing and increasing trend towards modernization in the use of dry cell batteries, chemical Burns may be on the decline, and we sought to investigate this. Methods: The records of all acute burn patients seen at the Burns and Plastic Department of the National Orthopaedic Hospital Enugu Nigeria between January 2011 and December 2014 were retrospectively reviewed. The results were compared to similar studies carried out at the same centre. A questionnaire was administered to corrosive chemical (sulphuric and caustic soda) vendors to assess the trends in product sales and use in recent times. Results: A total of 624 acute burn cases were treated during the period;among which, 12 cases (1.9%) were chemical Burns. When compared with previous studies at the centre, Chemical burn cases were recorded as the lowest rate. The median age of patients was 24 years. There were eight males and four females. Interpersonal assault was the commonest mechanism of injury with sulphuric acid suspected to be the commonest agent in 83.3% of the cases, while 16.7% of the cases were from accidental use of caustic soda. The head and neck as well as the upper limbs were the most affected (30%). Twenty-six questionnaires to lead-acid vendors were analyzed and revealed that all respondents noticed a marked downward trend in the sale of either sulphuric acid or caustic soda, and they attributed this to the ready availability of imported alternatives to locally manufactured soap or wet lead-acid batteries. Ease of use, durability and convenience of the dry cell batteries were cited as principal reasons. Conclusion: There appears to be a downward t

关键词： Chemical Burns Interpersonal assault Lead-acid battery vendors Resource-limited country Modernization

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Topical antimicrobial agents for pediatric Burns

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Burns & Trauma 2017年第4期5卷 229-236页

作者： Robert Cartotto Ross Tilley Burn Centre Sunnybrook Health Sciences Centre University of Toronto Rm D 712 2075 Bayview Avenue Toronto ON M4N 3M5 Canada

While topical antimicrobial agents are indicated for most if not all burn wounds, the choice of a topical agent must consider many factors such as the wound depth, anticipated time to healing, need for surgical intervention, and the known cytotoxicity of the agent. Especially relevant to the pediatric burn patient are the antimicrobial agent's properties related to causing pain or irritation and the required frequency of application and dressings. This article will discuss the general principles surrounding the use of topical antimicrobials on burn wounds and will review the most common agents currently in use.

关键词： Burns Topical antimicrobial Infection Dressings Wound Pediatric

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A rare case of failed healing in previously burned skin after a secondary Burns

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Burns & Trauma 2017年第4期5卷 268-271页

作者： Stephen J. Goldie Shaun Parsons Hana Menezes Andrew Ives Heather Cleland Victorian Adult Burns Service Alfred Hospital Melbourne Australia Department of Surgery Monash University Melbourne Australia Victorian Adult Burns Service Alfred Hospital Melbourne Australia

Background:Patients presenting with large surface area Burns are common in our practice;however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. Case presentation:We report on an unusual case of a patient sustaining a secondary large burn to areas previously injured by a burn from a different mechanism. We discuss the potential implications when managing a case like this and suggest potential biological reasons why the skin may behave differently. Our patient was a 33-year-old man who presented with a 5%TBSA burn on skin scarred by a previous 40%total body surface area (TBSA) burn and skin grafts. Initially assessed as superficial partial thickness in depth, the wounds were treated conservatively with dressings;however, they failed to heal and became infected requiring surgical management. Conclusions:Burns sustained in areas of previous burn scars and grafts may behave differently to normal patterns of healing, requiring more aggressive management and surgical intervention at an early stage.

关键词： Previous Burns Burn scar Non-healing

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Biobrane^(TM) for Burns of the pubic region: minimizing dressing changes

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Military Medical Research 2019年第1期6卷 89-92页

作者： Jia-Jun Feng Jia Le See Abby Choke Adrian Ooi Si Jack Chong Department of Plastic Reconstructive and Aesthetic Surgery Singapore General Hospital University of Auckland Faculty of Medical and Health Sciences

Background: The pubic region is often involved in accidental hot water or soup-spill Burns. Most of these wounds are superficial partial thickness Burns. Due to their proximity to the urinary system, as well as vaginal and anal openings,these Burns are easily contaminated. Daily dressings are routinely prescribed as the sole treatment. The cumbersome dressing process is uncomfortable and embarrassing for patients. Biobrane^(TM) is a bilayered biosynthetic dressing. Its coverage of superficial partial thickness Burns promotes wound healing and allows one-time application.Case presentations: We report two patients who suffered superficial dermal Burns over their pubic region. One patient had 23% total body surface area(TBSA) Burns over her lower abdomen, both thighs and pubic region. The second patient had 10% TBSA Burns that involved her perineum and the medial sides of both thighs and buttocks.Both were managed with the standard resuscitation protocol in the initial phase. Their burn injuries were managed by shaving, Foley catheterization and Biobrane^(TM) coverage. Their wounds healed uneventfully without complications.Full epithelization was achieved by post-operative day seven. Both patients consented to medical photography and academic publication.Conclusions: Shaving and catheterization improved the hygiene of the Burns of the pubic area. The Biobrane^(TM)method circumvents the need of regular dressing changes, eliminating the pain due to dressing changes and preserving patient dignity.

关键词： Pubic Thermal Burns Perineum Dressing BiobraneTM

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