Management of severe burn injuries in neonates

Although rare, burns suffered by neonates can be fatal. Many complex difficulties are faced during the management of burns in neonates because of the neonate's complex physiological and pathological changes. We compiled a retrospective review from the treatment of four burned neonates (including a premature neonate). All four neonates suffered bath-related burns in the hospital as a result of careless nursing when being bathed. The total body surface area burned ranged from 1 to 60% in these patients, and all survived the burn injury. All the patients were treated in the Burn Intensive Care Unit with close co-operation of burn surgeons and neonatologists. Based on our experience as well as a review of literature, management recommendations are proposed as the following: 1) prompt and aggressive fluid resuscitation, 2) early administration of oxygen and keeping the patient warm, 3) application of specific biological dressing and recombinant human growth hormone if necessary, 4) establishment of a multidisciplinary team, and 5) removal of necrosis tissue early and aggressively. Furthermore, a very important issue is also discussed, which is about the prevention of newborn burns in the neonate unit in developing countries.