Sankale A A, Ndiaye A, Ndoye A, Ndiaye L, Ndoye M
Service de Chirurgie Pédiatrique, Hôpital Aristide Le Dantec, Dakar, Sénégal.
Ann Burns Fire Disasters. 2011 Mar 31;24(1):34-8.
The skin is the body's protective barrier and is very much exposed to assaults and thus to burns. The aim of this work is to consider the special features of cervicofacial burns sequelae in children in a sub-Saharan environment and to review their management. This retrospective study, performed in the Department of Paediatric Surgery at Aristide Le Dantec Teaching Hospital in Dakar (Senegal), examined 27 patient files dating between May 2001 and April 2008. The children’s average age at first visit was 6.7 years and the m:f sex ratio was 1.7:1. The sequelae were topographically distributed as follows: face (66.7%), neck (29.6%), scalp (11.1%). Regarding the type of sequelae observed, adhesions predominated (33.3%), followed by keloid or hypertrophic scars (25.9%), eyelid ectropions (18.5%), scalp alopecias (11.1%), chronic ulcerations (7.4%), and discolorations (3.7%).Surgical treatment was used in 55.7% of the cases: Z-plasty, followed or not followed by skin graft for adhesion treatment, as well as adhesion lysis followed by grafting for eyelid ectropion treatment. The surgical morbidity rate was 20% and no mortality was reported. Keloid scars were treated medically with intralesional corticosteroid injections. Apart from the emergency situation, cervicofacial burns in children lead to severe aesthetic and functional damage. Any improvement in prognosis in such burns depends on improvements in the quality of initial care and on raising parents' awareness of accidents in the home.
皮肤是人体的保护屏障,极易受到伤害,进而遭受烧伤。本研究旨在探讨撒哈拉以南地区儿童面颈部烧伤后遗症的特点,并回顾其治疗方法。这项回顾性研究在达喀尔(塞内加尔)阿里斯蒂德·勒丹泰克教学医院小儿外科进行,研究了2001年5月至2008年4月期间的27份患者病历。患儿首次就诊时的平均年龄为6.7岁,男女比例为1.7:1。后遗症的部位分布如下:面部(66.7%)、颈部(29.6%)、头皮(11.1%)。观察到的后遗症类型中,粘连占主导(33.3%),其次是瘢痕疙瘩或增生性瘢痕(25.9%)、眼睑外翻(18.5%)、头皮脱发(11.1%)、慢性溃疡(7.4%)和色素沉着(3.7%)。55.7%的病例采用了手术治疗:Z成形术,粘连治疗时是否联合植皮,以及眼睑外翻治疗时先进行粘连松解再植皮。手术发病率为20%,无死亡病例报告。瘢痕疙瘩采用病灶内注射皮质类固醇进行药物治疗。除紧急情况外,儿童面颈部烧伤会导致严重的美观和功能损害。此类烧伤预后的任何改善都取决于初始护理质量的提高以及提高家长对家庭意外事故的认识。