The changing pattern of pediatric burns.

After scalds, flame burns have been considered the next most common mode of burn injury in childhood. Recent experience in the authors' unit suggested that contact burns were becoming more frequent. The authors sought to determine the contemporary frequency of different burn modalities in children presenting to a burns unit. A retrospective review of 3621 children treated in the burns unit, both ambulatory and inpatient, at the authors' institution between January 2003 and December 2007 was performed. Patients were identified using the Burns Unit database. Data collected included age, gender, burn etiology and site, TBSA, and whether operative surgery was required. Of the 3515 patients eligible for inclusion, scalds accounted for 55.9%, contact 30.5%, and flame 7.9% of all burns. Contact burns were shown to be consistently more frequent than flame burns for every year of the study (z = 17.30, P < .001). No seasonal variation was demonstrated amongst contact burns, reflecting the variety of mechanisms involved. The data suggest a change in the historical pattern of pediatric burns previously reported in the literature. These findings have implications for public health awareness and burns prevention campaigns.

Exhaust burns in children.

BACKGROUND: Contact thermal injuries appear the second most frequent cause for burns in children seen at our unit. Burns caused by hot exhaust systems represent an important subgroup, as these injuries carry the potential for considerable morbidity. METHODS: A retrospective review of the Burns Unit database was conducted from January 2003 to January 2008. All patients referred to our unit with burns caused by contact with an exhaust system were included. The morbidity associated with each injury was determined by recording the need for surgical intervention, days taken to heal and the number of hospital visits required. RESULTS: A total of 97 patients were identified, of which 71 were male (M:F; 2.7:1). Age ranged from 5 months to 15 years. The mechanisms involved were contacts with the exhaust systems of motorbikes, including mini-bikes and Pee-Wee bikes (77), cars (14), lawnmowers (5) and quad-bikes (1). The injuries most commonly occurred during the summer holiday months (n=36, 37%). The Total Body Surface Area (TBSA) ranged from 0.5% to 8%, although injuries measuring 1% or less accounted for 60% of the total. More than two-thirds of the injuries were located on the lower extremity, with the calf being the most common site. Surgical intervention was required in 33% of the cases. The average time taken for complete healing was 20 days with an average of 3.5 visits made for each injury. CONCLUSIONS: The rate of surgical intervention and days to healing clearly demonstrate the morbidity associated with these injuries. In addition the time, effort and money spent for their management appear considerable. A concerted effort must be made to raise public awareness regarding these injuries with a focus on educating people on the hazards of the equipment and the use of appropriate protective gear.