|Year : 2013 | Volume
| Issue : 1 | Page : 55-57
A study of burns in pediatric age group
Milind Anil Mehta1, Vijay Yashpal Bhatia1, Buddhi Prakash Sharma2
1 Department of Plastic Surgery, N.H.L. Medical College and V.S. Hospital, Ahmedabad, Gujarat, India
2 Department of Burns, N.H.L. Medical College and V.S. Hospital, Ahmedabad, Gujarat, India
|Date of Web Publication||22-Nov-2013|
Buddhi Prakash Sharma
Department of Burns, N.H.L. Medical College and V.S. Hospital, Ahmedabad, Gujarat
Source of Support: None, Conflict of Interest: None
Introduction: In the majority of pediatric burns mortality and morbidity results from simple domestic accidents that are preventable. Aim: A prospective study of pediatric burns was carried out at our burns unit to outline the epidemiology and management of the pediatric burns problem. Materials and Methods: Epidemiological data collected included age, sex, seasonal variation, place of burn, family size, economic status, period of time between the accident and admission to hospital. The cause and mode of burns, management of burns, relationship between mortality and age, cause and extent of burn was also noted. Results: A total of 72 pediatric patients of burns were admitted to our unit over a 3 years period. The highest incidence of burns was seen in the period of winter months between October and March. Males were affected more commonly as compared with females. The majority of the burns occurred at home. Most of the patients belonged to the low socio-economic strata and were members of medium or large size families. The most common type of injury was scald burns in children under 6 years of age and flame burns in the older children (6-12 years). The overall mortality was 13.88%. Conclusions: Burns injuries could be prevented by improving the home environment and socio-economic living conditions. Prevention can be achieved by education of adults as well as children about preventable aspects of burns.
Keywords: Epidemiology, pediatric burns, burn prevention
|How to cite this article:|
Mehta MA, Bhatia VY, Sharma BP. A study of burns in pediatric age group. Indian J Burns 2013;21:55-7
| Introduction|| |
Children have often been exposed because of their greater vulnerability to accidents owing to their inability to recognize and evaluate hazardous situations. 
Pediatric burns constitute a substantial proportion (16.6%) of total burn admissions. High mortality, long-term rehabilitation, cosmetic disfigurement, pain and trauma of dressing, hospitalization and emotional adjustments in an immature child add to the tragedy, initially for parents and later on for the victims. 
Thermal injuries in childhood are complex problems, which not only leave scars on the skin of the child, but more importantly result in scarring of the child's personality.
| Materials and Methods|| |
A study was conducted on burn patients aged younger than 12 years who were admitted to our burns ward between August 2006 and June 2009. We evaluated 72 children with burn injuries. Data about age, sex, burn size (% total body surface area [TBSA]), depth of injuries and etiology of burns were obtained in all cases. Epidemiological data included age, sex, seasonal variation, place of burn, family size, economic status, period of time between the accident and admission to hospital. Patients were stratified by age, sex, burn size (% TBSA) and depth of injuries and etiology of burns. Children were divided into three groups based on their ages as: 0-2, >2-6 years, >6-12 years. Injuries were classified as scalds, flame, contact, electrical or explosion. Outcome was recorded as patient survival or death based on their etiology. Children have proportionally larger body surface area (BSAs) than adults; TBSA burns were estimated using the pediatric modifications to Lund-Browder tables, which demonstrate the relatively larger head and small thigh. Pediatric resuscitation protocols are based on the following formula (H is height [cm], W is weight [kg]): BSA = [87(H + W) − 2600]/10,000.
All patients with partial-thickness burns greater than 10% of TBSA in patients who are younger than 10 years, partial-thickness burns over more than 5% of TBSA in age under 3 years, any burn in a neonate, electrical burns, chemical burns and burns involving the face, hands, feet, genitalia, perineum or major joints were admitted. Surgeries were performed in the form of split thickness grafting (STG), tangential excision and STG.
| Results|| |
In our prospective study of 72 children of pediatric burns who were admitted in our burns ward, 75% children were below the age group of 6 years, male to female ratio was 1.4:1 [Table 1]. Majority of burns were seen during winter and festival season in October and November months. Scald burns were the most common cause in children below 6 years whereas flame was common above 6 year of age [Table 2]. The majority of the burns occurred at home. Most of the patients belonged to the low socio-economic strata and were members of medium or large size families. 59.7% children having burns were below 20% BSA [Table 3]. Trunk was the most common site affected, i.e., 77.7%. Overall mortality was 13.88% [Table 4]. There was no mortality below 20% BSA burns. Mortality was more common below 4 year of age group. Most of the patients were discharged within 2 weeks of hospitalization [Table 5].
|Table 5: Treatment modalities and duration of hospital stay of burns patients|
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| Discussion|| |
The overall incidence of pediatric burns (<12 year age group) was 16.6% of total admitted patients. In our study, 47.22% of the patients (up to 12 year age group) admitted to the burns ward were children aged 2-6 years. In the study of Mukerji et al.  and Morrow et al.,  33% and 21.6% incidence was noted respectively. The higher incidence in this age is probably due to inquisitive nature of children. In this study, scalding was the most common type of burn injury, i.e., 68.05%, particularly between the ages of 0 and 6 years. This is because children while exploring new things accidently put hands in hot water or bath tub or spill hot liquids. The mortality rate in our study was 13.88% as compared with 19.7% mortality in Gupta et al.  series and 21.8% in Mukerji et al.  series. In our study, the male-to-female ratio was 1.4:1. A similar finding was observed in some other studies such as Mukerji et al.  and Marrow et al.  In non-operative group, average hospital stay was 14.5 days while in operative group, it was 34 days. 60% of children who were applied collagen were discharged after 1 week, 20% in 2 nd week and remaining 4% in 3 rd week. Dry collagen was used, which is a bovine based extracellular matrix native collagen membrane. Collagen application reduced the hospital stay as well as pain due to dressings, which was carried out on alternate days if collagen was not applied. Collagen dressings were removed on 7 th day [Figure 1], [Figure 2], [Figure 3] to [Figure 4] shows a child from admission to complete healing).
| Conclusion|| |
Children admitted to our burns ward were predominantly below the 6 years of age, i.e., 75% of total. Males were more commonly involved, i.e., 59.25%. Most burns occur in winter and festival season due to the frequent use of hot water and tea, which leads to scald. Also, the use of poor quality fire cracker and their use by children without supervision by adults leads to flame burns. Mortality was more common below 4 year of age group, in flame burns with inhalational injury and in those children where there was an increased time lapse between burn injury and start of fluid resuscitation. Burns injuries could be prevented by improving the home environment and socio-economic living conditions through the health, social welfare, education and housing departments. Prevention can be achieved by education of adults as well as children about preventable aspects of burns.
| References|| |
|1.||East MK, Jones CA, Feller I. Epidemiology of burns in children. In: Carvajal HF, Parks DH, editors. Burns in Children: Pediatric Burn Management. Chicago: Year Book Medical Publisher; 1988. p. 3-10. |
|2.||Mukerji G, Chamania S, Patidar GP, Gupta S. Epidemiology of paediatric burns in Indore, India. Burns 2001;27:33-8. |
|3.||Morrow SE, Smith DL, Cairns BA, Howell PD, Nakayama DK, Peterson HD. Etiology and outcome of pediatric burns. J Pediatr Surg 1996;31:329-33. |
|4.||Gupta M, Gupta OK, Goil P. Paediatric burns in Jaipur, India: An epidemiological study. Burns 1992;18:63-7. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]