Multicentre observational study describing the systemic response to small-area burns in children.

BACKGROUND AND OBJECTIVES: Burns of less than 10% total body surface area (TBSA) are common injuries in children under five years of age. The inflammatory response to burn injury is well recognised for burns greater than 20% TBSA but has not been described for smaller burns. The aim of this study was to describe the systemic response to burn injury in young children with small-area burns. METHODS: The Morbidity In Small Thermal Injury in Children study (MISTIC) was a multicentre prospective observational cohort study that recruited 625 patients under five years of age with burns of less than 10% TBSA over eighteen months across three sites in England. Prospectively collected data included physical observations and laboratory blood tests taken in hospital as part of routine care. Additional information was sourced from temperature recordings taken at home following discharge. RESULTS: Elevated temperatures were observed in children with scald or contact burns between 2-10% TBSA, with a peak on day one after burn followed by a fall over days four to seven after burn. No temperature rise was seen in children with burns of <2% TBSA. Higher temperature readings were associated with larger burn size, age under two years and male sex. Heart rate and C-Reactive Protein levels showed a peak on day three after burn. CONCLUSIONS: An identifiable systemic inflammatory response to small-area burns in young children is reported. This knowledge can be used to aid in the diagnosis of children with a burn injury who re-present with a pyrexia, and no other symptoms to indicate clinical infection.

155 burns caused by hair straighteners in children: a single centre's experience over 5 years.

UNLABELLED: Hair straighteners have become a popular and common household appliance. The incidence of burns from these devices is rising, and is of particular concern given that the main casualties are infants. We present the largest case series in the literature of paediatric burns from hair straightening devices. METHODS: Retrospective data collection of all burns by hair straightening devices presenting to our unit between 2007 and 2011. Details on demographics, time and mechanism of injury, size and depth of injury and treatment received were recorded. RESULTS: There were 155 cases in the five-year period. The mean age was 19 months. The majority of the burns were caused by a 'touch/grab' (49%) or 'stepped-into' (14%) mechanism. The area most frequently burnt was the hand with 60% of the injuries. 8 out of the 155 required excision and grafting. CONCLUSION: Hair straightening devices can reach temperatures of over 220°C and can cause significant full thickness injuries. Our study shows that infants and toddlers are at most risk. These are preventable burns that warrant our attention, and we would advocate the use of heat-resistant pouches and closure clips on the devices to help minimise the risk of injury.