Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
Burns. 2019 Nov;45(7):1518-1527. doi: 10.1016/j.burns.2018.11.005. Epub 2019 Jan 9.
Thermal injuries amongst infants are common and a cause of significant mortality and morbidity in South Africa. This has been attributed to the lack of an enabling environment (poverty-related lack of safe living conditions) and the cognitive and physical developmental immaturity of infants, who depend on their surroundings and adults to keep them safe. This is a retrospective observational study of 548 infant admissions over 48 months. Infant was defined as children below 13 months of age. The 548 infants constituted 23% of all paediatric burn admissions of ages 0-12 years. Three hundred and fourteen were males (57%) and 234 (42.7%) females. The infants were divided in a pre-ambulatory group of 143 (26%) infants of 0-6 months and an ambulatory group of 7 months to 12 months consisting of 457 (83.3%). The total body surface area (TBSA) ranged from 2-65%. Seventy-six percent (417 infants) occurred in the home environment. Scalds accounted for 86% (471 infants) and 6% (33 infants) were as a result of flame burns. Non-accidental injuries accounted for 1.2%. The anatomical distributions varied between the pre-ambulatory and ambulatory groups. Conservative management was done in 397 (72.4%) and 101(18.4%) infants underwent surgery. Infection was suspected in 76 (13.5%) infants with positive blood cultures in 15(20%) of the 76. ICU care was received in 46 (8.3%) infants and 15 (32.6%) of these had inhalation injuries. Of the inhalation injuries 11(23.9%) infants underwent mechanical ventilation of an average of 4.4 days. Ventilator associated pneumonia was diagnosed in 8(17%) of the ventilated children. The mortality rate was 0.36%. The surgically treated patients acquired more complications than the conservatively treated group. Special treatment considerations should be considered in this paediatric sub-group.
婴幼儿的烫伤很常见，也是南非儿童死亡率和发病率高的一个原因。这归因于缺乏有利环境（与贫困相关的缺乏安全生活条件）和婴幼儿认知和身体发育不成熟，他们依靠周围环境和成年人来保护他们的安全。这是一项对 48 个月内 548 例婴儿入院的回顾性观察研究。婴儿被定义为 13 个月以下的儿童。这 548 名婴儿占 0-12 岁儿科烧伤入院人数的 23%。其中 314 名男性（57%）和 234 名（42.7%）女性。婴儿分为 143 名（26%）0-6 个月的非步行婴儿的预步行组和 457 名（83.3%）7 个月至 12 个月的步行婴儿组。总体表面积（TBSA）范围为 2-65%。76%（417 名婴儿）发生在家庭环境中。烫伤占 86%（471 名婴儿），6%（33 名婴儿）是火焰烧伤的结果。非故意伤害占 1.2%。解剖分布在预步行组和步行组之间有所不同。397 名（72.4%）婴儿接受保守治疗，101 名（18.4%）婴儿接受手术治疗。76 名（13.5%）婴儿疑似感染，其中 15 名（20%）血液培养阳性。46 名（8.3%）婴儿接受 ICU 治疗，其中 15 名（32.6%）婴儿有吸入性损伤。吸入性损伤的 11 名（23.9%）婴儿接受了平均 4.4 天的机械通气。在接受机械通气的儿童中，有 8 名（17%）被诊断为呼吸机相关性肺炎。死亡率为 0.36%。接受手术治疗的患者比接受保守治疗的患者发生更多的并发症。在这个儿科亚组中应考虑特殊的治疗注意事项。
