Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, Shanghai, China; Clinic of the 91681 troop of PLA, Zhejiang, China.
Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Burn Institute of PLA, Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences, Shanghai, China.
Burns. 2023 Nov;49(7):1719-1728. doi: 10.1016/j.burns.2023.02.008. Epub 2023 Feb 22.
To describe the epidemiological and clinical features of paediatric scar inpatients and then to facilitate therapeutic schedule for children with scars.
In this cross-sectional study, data of patients admitted for scar treatment in 1064 tertiary hospitals from 2013 to 2018 were extracted through the Hospital Quality Monitoring System (HQMS) database. Demographic and clinical features of children with scars were analysed statistically and highlighted compared with those of adults and the elderly scar cases.
In this study, 53,741 paediatric scar cases, accounting for 30.29% of all hospitalized for scar, were analysed. Compared to adults and the elderly, children with scars were mainly males (62.27% vs 50.98% vs 49.85%, P < 0.001) and were vulnerable to scalds (37.10%) and operative intervention (34.11%). Although the scalp/face/neck was the most common affected location, the proportion of scars involving upper limbs (27.88% vs 21.69% vs 7.28%, P < 0.001), lower limbs (15.14% vs 10.28% vs 6.56%, P < 0.001) and perineum (4.59% vs 3.13% vs 2.65%, P < 0.001) was higher in children than that in other two groups. Scar contracture was the most common complications in children (45.27%). Nearly 66% of paediatric scar cases received surgical treatment during hospitalization, among whom release of lesion was the most frequent operation (56.35%). The proportion of keloids was relatively lower in child cases than in other two groups (6.20% vs 14.48% vs 18.15%, P < 0.001). Additionally, the median LOS in child cases was 9 (5-15) days, slightly exceeding that in adult/elderly cases.
Scars were common inducing factors of hospitalization and contributed greatly to the disease burden of children. More attention should be paid to those who are males, burn survivors, or skin-injured at extremities and perineum to improve therapeutic strategies and prognoses for paediatric scar patients.
描述儿科瘢痕住院患者的流行病学和临床特征，从而为瘢痕患儿制定治疗方案。
本横断面研究通过医院质量监测系统（HQMS）数据库提取了 2013 年至 2018 年期间 1064 家三级医院因瘢痕治疗而住院的患者数据。对瘢痕患儿的人口统计学和临床特征进行统计分析，并与成人和老年瘢痕患者进行比较。
本研究共分析了 53741 例儿科瘢痕病例，占所有因瘢痕住院患者的 30.29%。与成人和老年人相比，瘢痕患儿主要为男性（62.27%比 50.98%比 49.85%，P<0.001），且易受烫伤（37.10%）和手术干预（34.11%）影响。虽然头皮/面部/颈部是最常见的受累部位，但上肢（27.88%比 21.69%比 7.28%，P<0.001）、下肢（15.14%比 10.28%比 6.56%，P<0.001）和会阴（4.59%比 3.13%比 2.65%，P<0.001）的瘢痕比例在儿童中更高。瘢痕挛缩是儿童最常见的并发症（45.27%）。近 66%的儿科瘢痕病例在住院期间接受了手术治疗，其中松解病变是最常见的手术（56.35%）。儿童瘢痕病例中瘢痕疙瘩的比例相对低于其他两组（6.20%比 14.48%比 18.15%，P<0.001）。此外，儿童病例的中位 LOS 为 9（5-15）天，略高于成人/老年病例。
瘢痕是导致住院的常见原因，对儿童的疾病负担有很大影响。应更加关注男性、烧伤幸存者或四肢和会阴受伤的患者，以改善儿科瘢痕患者的治疗策略和预后。
