Murphy Pamela S, Kleinwachter Nancy, Medina Erica
J Pediatr Rehabil Med. 2019;12(4):369-374. doi: 10.3233/PRM-190607.
Spina Bifida (SB) is a congenital defect of the neural tube resulting in motor and sensory defects and frequently includes insensate skin on the buttocks and feet which are innervated by sacral nerves. For those living in hot climates such as the Southwestern United States, environmental surfaces reach temperatures throughout June-September that cause thermal burns. The objective of this novel case series was to evaluate the circumstances associated with environmental buttocks burns in children with SB who attend the District Medical Group Children's Rehabilitative Services Myelomeningocele (MM) Planning clinic in Phoenix, AZ.
Nine children and adolescents with SB and a history of environmental buttocks burns were identified through participation in the National Spina Bifida Patient Registry at District Medical Group Children's Rehabilitative Services Myelomeningocele Planning Clinic. Parents and patients were interviewed about the burn circumstances, charts were reviewed, and information was gathered from the NSBPR including level of function and ambulation status.
Most of the patients were found to be of emerging independent ages (average age 10 years) and were not with their parents at the time of the burn. All had myelomeningocele (MM), almost all were community ambulators, and all had mid lumbar, low lumbar or sacral level function. There were no non-ambulators. In addition, the majority were wearing incontinence products.
Children and adolescents with MM who are community ambulators, of an emerging independent age, and live in hot climates are at risk of environmental buttocks burns. Enhanced education in environmental thermal burn prevention is important. This education should be particularly focused on the child as they spend more time in settings without their parents. In addition, this enhanced education should extend to those who support the child or teen such as teachers, coaches, family and friends.
脊柱裂（SB）是一种神经管先天性缺陷，会导致运动和感觉功能缺陷，通常包括由骶神经支配的臀部和足部皮肤感觉丧失。对于生活在美国西南部等炎热气候地区的人来说，6月至9月期间环境表面温度会导致烫伤。本新型病例系列的目的是评估在亚利桑那州凤凰城地区医疗集团儿童康复服务脊髓脊膜膨出（MM）规划诊所就诊的脊柱裂患儿发生环境性臀部烫伤的相关情况。
通过参与地区医疗集团儿童康复服务脊髓脊膜膨出规划诊所的国家脊柱裂患者登记系统，确定了9名有环境性臀部烫伤病史的脊柱裂儿童和青少年。对家长和患者进行了关于烫伤情况的访谈，查阅了病历，并从国家脊柱裂患者登记系统收集了包括功能水平和行走状态等信息。
发现大多数患者处于逐渐独立的年龄（平均年龄10岁），烫伤发生时未与父母在一起。所有患者均患有脊髓脊膜膨出（MM），几乎所有人都能在社区行走，且都具有中腰、低腰或骶部水平功能。没有不能行走的患者。此外，大多数患者都穿着失禁用品。
能在社区行走、处于逐渐独立年龄且生活在炎热气候中的脊髓脊膜膨出患儿和青少年有发生环境性臀部烫伤的风险。加强环境性热烧伤预防教育很重要。这种教育应特别关注孩子，因为他们在没有父母陪伴的环境中待的时间更长。此外，这种强化教育应扩展到支持儿童或青少年的人，如教师、教练、家人和朋友。
