Kassira Wrood, Namias Nicholas
University of Miami/Jackson Memorial Burn Center, Jackson Memorial Hospital and the University of Miami Miller School of Medicine, Miami, Florida 33101, USA.
J Craniofac Surg. 2008 Jul;19(4):1007-9. doi: 10.1097/SCS.0b013e318175f440.
The leading etiologies of pediatric burns are scald, thermal, and electrical injuries. The initial management of burns involves assessment of burn depth and total body surface area (TBSA) affected, a history, and physical examination. Calculation of percent of TBSA affected is an important determinant of the necessity for hospitalization versus outpatient management. Only second- and third-degree burns are included in the calculation. The criteria for outpatient management vary based on the center experience and resources. One such set of criteria in an experienced burn center includes burn affecting less than 15% TBSA, therefore not requiring fluid resuscitation; the ability to take in oral fluids, excluding serious perioral burns; no airway involvement or aspiration of hot liquid; no abuse; and dependable family able to transport the patient for clinic appointments. Once the child is ready to reenter school, the physician must discuss with the family and school staff any needs and expectations for the child, including wound care. Social reintegration can be difficult. Educating the teachers and staff of the child's appearance may help prepare the students.
小儿烧伤的主要病因是烫伤、热烧伤和电烧伤。烧伤的初始处理包括评估烧伤深度和受影响的全身表面积（TBSA）、病史及体格检查。计算受影响的TBSA百分比是决定住院治疗还是门诊治疗必要性的重要因素。计算中仅包括二度和三度烧伤。门诊治疗的标准因中心经验和资源而异。在一个经验丰富的烧伤中心，一套这样的标准包括：烧伤面积小于15%TBSA，因此无需液体复苏；能够摄入口服液体，不包括严重的口周烧伤；无气道受累或热液误吸；无虐待情况；以及有可靠的家庭能够送患者到诊所就诊。一旦孩子准备好重返学校，医生必须与家长和学校工作人员讨论对孩子的任何需求和期望，包括伤口护理。重新融入社会可能会很困难。让教师和工作人员了解孩子的外貌情况可能有助于让学生做好准备。
