Burns injuries in children
18th June 2013
In the UK, children account for approximately half of all burn injuries, the overwhelming majority of which are due to scald injuries; 180 children attend Accident and Emergency departments each day with scald injuries due to hot drinks alone. Other common causes of injury in children include burns due to direct contact with a hot object, for example radiators, hair straighteners and irons. Burns injuries from flames, electrical current and chemicals are less common but are often significant in terms of the damage done when they do occur.
The severity of a burn injury in a child will be calculated from an assessment of the percentage of body surface affected, and the depth of damage done to the skin. Larger burns (5% of the body surface area and above) are generally referred on to specialist burns services for care, as are smaller deep injuries, and injuries to delicate or very functional parts of the body, such as the face and the perineum.
In the UK, the vast majority of burn doctors are fully trained plastic surgeons, and as such are able to deal with both the acute stages of burn care as well the potentially complex matter of long term reconstruction. They work closely along with a team of other medical, nursing and other allied professionals, including play therapists and child psychologists, in recognition of the possible complex needs of the patients and their families.
A number of surgical innovations have led to improvements in the outcome for the burned patient. Rapid removal of non-viable burned tissue in the early stages of care has led to improved chance of survival, whilst the use of laboratory produced dermal substitutes has helped surgeons to achieve more rapid healing in larger burns; these same dermal substitutes have also produced a benefit in the quality of scar tissue in the healed wound, and are also used to help heal smaller wounds in some specialised parts of the body. Recently, the focus in surgery has shifted to preserving the deeper layer of the skin (dermis) when possible, with an associated improvement in the quality of the scar left behind. This is possible due to advances in diagnosing the depth of the burn with laser scanning, and more precise and delicate methods of tissue debridement made possible with the help of hydro-dissecting scalpels.
Whilst the laboratory manufacture of a biological skin in its entirety still eludes us, the cumulative effect of these advances and others, have led to dramatic improvements in care, survival and long-term outcome of the burned patient.
To find out more about Child Safety Week (18 – 24 June) visit http://www.childsafetyweek.org.uk
Joanne Atkins
Full Member of BAPRAS
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