Soueid Ali, King Helen, Wilson Yvonne T
Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK.
J Plast Reconstr Aesthet Surg. 2008;61(5):540-5. doi: 10.1016/j.bjps.2007.01.010. Epub 2007 Mar 2.
Children with burns inflicted by other children represent a small proportion of referrals to our paediatric burns unit. The aim of this paper is to investigate any differences between them.
Prospective observational audit.
Children admitted between January 1998 and December 2003.
Forty-seven patients were admitted to our paediatric burns unit with burns inflicted by other children, of which 38 were male. Scalds were the cause of 53% of all the injuries. Two distinct groups were identified; one group had their burns inflicted by other children accidentally (Group A) and another reported their burns as inflicted by other children intentionally (Group B). The majority had less than 10% total body surface area (TBSA) burns sustained at home. Thirteen patients (27.7%) were reported as deliberate (Group B). The majority in Group B were males (90.9%, P>0.0001) with a median age of 12 years (P>0.0001) who sustained flame burns (P>0.0001) outdoors with a greater %TBSA (mean 12.1% versus 3.8% for Group A) and higher percentage of full thickness burns (38.5% versus 20.6% of group A). More children from Group B had separated parents (53.9% versus 5.9%) and came from poorer socioeconomic backgrounds (69.2% versus 8.8%). All the cases that required ITU admission came from this category. These patients required more surgery as compared to the accidental group (61.5% versus 26.4%). Children from Group B required prolonged periods of outpatient follow up (53.8% versus 14.7% from Group A) and a greater proportion of these children failed to keep outpatient follow-up appointments as compared to the accidental group (38.5% versus 23.5% of Group A, P=0.0007).
Older male children sustained significant burns outside their homes. They reported them as being deliberate assaults, although on closer inspection of the circumstances it was difficult to support their account of the events.
因其他儿童造成烧伤而被转诊至我院儿科烧伤病房的患儿占比很小。本文旨在研究他们之间的差异。
前瞻性观察性审计。
1998年1月至2003年12月期间收治的患儿。
47例因其他儿童造成烧伤的患儿被收治入我院儿科烧伤病房，其中38例为男性。烫伤占所有损伤原因的53%。确定了两个不同的组；一组是被其他儿童意外烧伤（A组），另一组称其烧伤是被其他儿童故意造成的（B组）。大多数患儿全身烧伤面积（TBSA）小于10%，在家中受伤。据报告13例（27.7%）为故意烧伤（B组）。B组大多数为男性（90.9%，P>0.0001），中位年龄12岁（P>0.0001），在户外遭受火焰烧伤（P>0.0001），TBSA百分比更高（A组平均为12.1%，B组为3.8%），全层烧伤百分比更高（B组为38.5%，A组为20.6%）。B组更多儿童的父母离异（53.9%对5.9%），且来自社会经济背景较差的家庭（69.2%对8.8%）。所有需要入住重症监护病房的病例均来自该组。与意外烧伤组相比，这些患者需要更多的手术（61.5%对26.4%）。B组患儿需要更长时间的门诊随访（53.8%对A组的14.7%），与意外烧伤组相比，这些患儿中未能按时进行门诊随访预约的比例更高（B组为38.5%，A组为23.5%，P=0.0007）。
年龄较大的男性儿童在家外遭受严重烧伤。他们称这些烧伤是故意袭击所致，尽管仔细审查情况后很难证实他们对事件的描述。
