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Pediatric superficial scald burns--reassessment of our follow-up protocol
Francesco M Egro1, Jennifer K O'Neill, Robert Briard
1Department of Plastic Surgery, Frenchay Hospital, Bristol, UK.
Insights
Superficial scalds in children rarely develop hypertrophic scars if healed within two weeks. An experienced burns team can accurately predict at the two-week follow-up which patients need no further scar management, reducing clinic visits.
Area of Science:
- Pediatric Burn Care
- Dermatology
- Wound Healing
Background:
- Superficial scalds are the most common pediatric burn injury.
- Current protocols involve follow-up at 2 weeks and 2 months post-injury.
- The necessity of the second follow-up warrants investigation.
Purpose of the Study:
- To assess the need for the second follow-up in the current pediatric burn care protocol.
- To evaluate the reliability of predicting scar development at the 2-week mark.
- To determine if the follow-up protocol can be safely modified to reduce clinic attendances.
Main Methods:
- Retrospective review of pediatric scald cases (under 16 years, >5% TBSA) assessing healing and scar development up to 5 years.
- Prospective study over 10 months including children with superficial partial-thickness scalds.
- Prediction of further follow-up needs at the 2-week appointment and assessment of prediction accuracy at 2 months.
Main Results:
- Scalds healing within 2 weeks rarely resulted in hypertrophic scarring.
- An experienced burns team could reliably predict at the 2-week appointment which children required no further scar management.
- The prediction accuracy at 2 months was confirmed.
Conclusions:
- It is safe to modify the current pediatric burn follow-up protocol.
- Reducing clinic attendances by eliminating the second follow-up is feasible.
- This modification can streamline care for pediatric superficial scald injuries.
Abstract:
The most common pediatric burn injury is a superficial scald. The current follow-up protocol for such burns includes review of the patient at 2 weeks postinjury and then 2 months later. The authors decided to review the protocol to assess the need for this second follow-up. A retrospective study reviewed the case notes of patients younger than 16 years at the time of their injury presenting with a scald over 5% TBSA. The progress of healing and scar development up to 5 years follow-up was assessed. This study showed that scalds healing within 2 weeks following injury rarely became hypertrophic. A prospective study was performed over a 10-month period. All children who suffered a superficial partial-thickness scald injury were included. At the 2-week appointment, the need for further follow-up was predicted. The accuracy of this prediction was assessed 2 months later. This study showed that an experienced member of the burns team could reliably predict at 2-week appointment those children who could be safely discharged with no subsequent need for scar management. This study suggests that it will be safe to modify the follow-up protocol, reducing the number of clinic attendances.
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