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Osteomyelitis in burn patients requiring skeletal fixation
J P Barret1, M H Desai, D N Herndon
1Department of Surgery, Shriners Burns Hospital and The University of Texas Medical Branch, Galveston, TX, USA. j.p.barret.nerin@chir.azg.nl
Summary
Skeletal fixation is safe for severely burned children, with a low risk of infection. This treatment is recommended for exposed deep structures and positioning, though optimal pin removal timing requires further study.
Area of Science:
- Orthopedic Surgery
- Burn Care
- Pediatric Traumatology
Background:
- Severe burns frequently expose musculoskeletal structures, necessitating skeletal fixation.
- Osteosynthesis materials can increase infection risk, including osteomyelitis, in burn patients.
Purpose of the Study:
- To evaluate the safety and infectious complication rates of skeletal fixation in pediatric burn patients.
- To assess the association between complications like loose pins and osteomyelitis.
Main Methods:
- Retrospective review of pediatric patients with severe burns treated with pin insertion over 10 years.
- Analysis of 357 skeletal fixation procedures in 41 children with extensive full-thickness burns.
Main Results:
- A low incidence of infectious complications was observed: 3.6% loose pins, 4.8% pin site cellulitis, and 4.8% osteomyelitis.
- No significant association was found between loose pins, cellulitis, wound infection, or sepsis and the development of osteomyelitis.
Conclusions:
- Skeletal fixation is a safe procedure in severely burned pediatric patients, with a low rate of infectious complications.
- Consider skeletal fixation for managing exposed deep structures and for positioning in severe burn cases.
- Further research is needed to determine the optimal timing for pin removal in burn patients.