Keck School of Medicine, Los Angeles, California.
LAC + USC Medical Center Burn Unit, Los Angeles, California.
J Burn Care Res. 2020 Sep 23;41(5):1029-1032. doi: 10.1093/jbcr/iraa115.
American Burn Association (ABA) guidelines recommend that all pediatric burns be transferred to a burn center if their presenting hospital lacks the necessary personnel or equipment for their care. Our institution often treats small burns (<10% TBSA) in pediatric patients in an ambulatory setting with a nondaily dressing. The aim of this study was to determine whether small pediatric burns could be safely managed on an outpatient basis. A retrospective review at a single ABA-verified burn center was conducted, including 742 pediatric patients presenting to the burn evaluation clinic in a 3-year period. Postburn day, age, sex, TBSA, burn etiology, body area burned, burn dressing type, outpatient versus inpatient management, reason(s) for admission, and any operative intervention were collected. Overall, the most common burn etiologies were scald (68%), contact (20%), and flame (5%). In this cohort, 14% (101) of patients were admitted on evaluation to the burn center with a mean TBSA of 9%. The remaining 86% (641) of patients were treated outpatient with a mean TBSA of 3%. Of those who were treated outpatient, 96% (613) successfully completed outpatient care and 4% (28) were subsequently admitted. The patients who were successfully managed in an ambulatory setting had a mean TBSA of 3%, whereas the patients who failed outpatient care had a mean TBSA of 4%. The primary reason for the subsequent admission of these patients was nutrition optimization (61%). The vast majority of small pediatric burns can be effectively treated on an outpatient basis with a nondaily dressing.
美国烧伤协会 (ABA) 指南建议，如果患儿所在医院缺乏必要的人员或设备来进行治疗，所有儿科烧伤都应转至烧伤中心。我们机构经常在门诊环境下使用非每日更换的敷料来治疗小儿患者的小面积烧伤（<10% TBSA）。本研究旨在确定小儿小面积烧伤是否可以安全地在门诊进行管理。对一家经 ABA 认证的烧伤中心进行了回顾性研究，包括在 3 年期间到烧伤评估诊所就诊的 742 名儿科患者。收集了烧伤后天数、年龄、性别、TBSA、烧伤病因、身体烧伤面积、烧伤敷料类型、门诊与住院管理、入院原因以及任何手术干预等信息。总体而言，最常见的烧伤病因是烫伤（68%）、接触（20%）和火焰（5%）。在该队列中，14%（101 名）患者在烧伤中心评估时入院，平均 TBSA 为 9%。其余 86%（641 名）患者在门诊接受治疗，平均 TBSA 为 3%。在门诊接受治疗的患者中，96%（613 名）成功完成了门诊治疗，4%（28 名）随后入院。在门诊环境下成功管理的患者平均 TBSA 为 3%，而门诊治疗失败的患者平均 TBSA 为 4%。这些患者随后入院的主要原因是营养优化（61%）。绝大多数小儿小面积烧伤可以通过使用非每日更换的敷料在门诊进行有效治疗。
