Al-Ahdab Maher, Al-Omawi Maimouna
Security Forces Hospital Program, Riyadh, Saudi Arabia.
J Burn Care Res. 2011 Jan-Feb;32(1):e1-6. doi: 10.1097/BCR.0b013e318203354f.
No previous publication about domestic neonatal burns exists in the literature. The authors have treated a 16-day-old baby boy for deep partial-thickness scalds that happened at home. The case report is followed by a literature review and discussion of the data previously published on neonatal burns. Special considerations to domestic neonatal burns are highlighted. A 16-day-old baby boy presented to our emergency room secondary to an 18% TBSA scald burn by hot tea. The patient was resuscitated and admitted to the pediatric intensive care unit. Topical wound care, although started with fusidic acid ointment, was changed to Aquacel Ag Hydrofiber dressing once the final depth assessment was performed. The child's wounds, although deep at some areas, healed by day 11 without the need for skin grafting. Neonatal burns have been previously described as iatrogenic injuries caused by various thermal sources. Part of the challenge in managing burns is their extremely thin skin. Possibility of the burn being inflicted should always be raised for such young victims. Burn wounds are tetanus-prone wounds; however, no previous recommendation regarding tetanus immunoglobulin administration exists for neonatal burns. Aquacel Ag's efficacy in the management of pediatric partial-thickness burns has been documented extensively and from our limited experience, it seems appropriate for managing neonatal burns. Although neonatal burns need some special considerations during treatment, the cornerstones of pediatric burn management still apply. The role of tetanus immunoglobulin still needs to be studied.
文献中尚无关于国内新生儿烧伤的既往出版物。作者治疗了一名16天大的男婴，其在家中发生了深Ⅱ度烫伤。病例报告之后是对先前发表的有关新生儿烧伤数据的文献综述和讨论。强调了对国内新生儿烧伤的特殊考虑因素。一名16天大的男婴因18%体表面积的热茶烫伤被送至我们的急诊室。患者接受了复苏并入住儿科重症监护病房。局部伤口护理最初使用夫西地酸软膏，在进行最终深度评估后改为藻酸盐银水凝胶敷料。患儿的伤口虽然在某些部位较深，但在第11天愈合，无需植皮。新生儿烧伤先前被描述为由各种热源引起的医源性损伤。烧伤管理的部分挑战在于其皮肤极其薄。对于如此年幼的受害者，应始终考虑烧伤是否为人为造成的可能性。烧伤创面是易感染破伤风的伤口；然而，此前尚无关于新生儿烧伤破伤风免疫球蛋白给药的建议。藻酸盐银水凝胶敷料在小儿浅Ⅱ度烧伤管理中的疗效已得到广泛记录，根据我们有限的经验，它似乎适用于新生儿烧伤的管理。尽管新生儿烧伤在治疗期间需要一些特殊考虑，但小儿烧伤管理的基本原则仍然适用。破伤风免疫球蛋白的作用仍需研究。
