Department of Pediatric Surgery, University Children's Hospital Zurich, Switzerland.
Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Switzerland; Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland.
Burns. 2019 Dec;45(8):1908-1917. doi: 10.1016/j.burns.2019.05.018. Epub 2019 Oct 7.
The objective of this study was to evaluate where and when pediatric burn injuries occurred. Furthermore the quality of first aid treatment, ratio of skin grafting and length of hospital stay were evaluated. The patient records of 749 children with acute burns admitted to the University Children's Hospital of Zurich, Switzerland, were retrospectively reviewed over an 11-year period. Burn injuries in children with an immigrant background were overrepresented in our study population, whereby the proportion of immigrants decreased with rising age. Sixty-five percent of all patients received some form of first aid. Of those 4.5% did not comply with the current guidelines. Furthermore initial assessment of total body surface area (TBSA) by the first line physician was overestimated in 76% of cases. Flame injuries occurred mainly in summertime in outdoor settings and needed significant more often skin grafts than scalds, which mainly occurred indoors and in wintertime. As a result, patients with flame injuries had to stay significantly longer in hospital (flames: 21 days (range: 1-259 days; median: 30; interquartile range (IQR): 30) versus scalds: 7 days (range: 1-130 days; median: 7; IQR: 12); p < 0.001). Furthermore high voltage injuries often resulted in lower-leg amputations (n = 3; 43%). Based on these facts, targets for the improvement of a prevention campaign and the treatment for burned children were named.
本研究旨在评估儿童烧伤的发生地点和时间。此外，还评估了急救治疗质量、植皮比例和住院时间。对瑞士苏黎世大学儿童医院收治的 749 名急性烧伤儿童的患者记录进行了回顾性分析，时间跨度为 11 年。在我们的研究人群中，具有移民背景的儿童烧伤比例过高，而随着年龄的增长，移民比例逐渐下降。所有患者中有 65%接受了某种形式的急救。其中 4.5%不符合当前指南。此外，一线医生对总体表面积（TBSA）的初步评估在 76%的病例中被高估。火焰烧伤主要发生在夏季户外环境中，比烫伤需要更多的植皮，烫伤主要发生在室内和冬季。因此，火焰烧伤患者的住院时间明显更长（火焰烧伤：21 天（范围：1-259 天；中位数：30；四分位距（IQR）：30）与烫伤：7 天（范围：1-130 天；中位数：7；IQR：12）；p<0.001）。此外，高压伤常导致小腿截肢（n=3；43%）。基于这些事实，确定了改善预防运动和烧伤儿童治疗的目标。
