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Survival of an infant with massive thermal injury: a case report
P D Thomson1, M L Bowden, K McDonald
1University of Michigan Medical Center, Department of Surgery, Ann Arbor.
Insights
Survival of infants with extensive burns is rare. This case report details the successful survival of an infant with an 80% total body surface area flame burn, highlighting early surgical intervention and comprehensive care.
Area of Science:
- Pediatric Burn Management
- Neonatal Intensive Care
- Trauma Surgery
Background:
- Survival rates for infants with extensive burns (>80% TBSA) are poorly documented.
- Severe burns in infants present unique challenges due to physiological immaturity.
Observation:
- A 4-month-old infant sustained an 80% total body surface area (TBSA) full-thickness flame burn.
- The National Burn Information Exchange identified 2266 infants (<8 months) treated for burns; only 4 had >80% TBSA full-thickness injury.
Findings:
- The infant survived despite the extensive burn injury, a statistically rare outcome.
- Early aggressive surgical excision of burn eschar was a critical factor in survival.
- The case represents the only documented survival among four infants with similar severe injuries.
Implications:
- Aggressive surgical management, including early eschar excision, can improve survival in infants with massive burns.
- Multidisciplinary care is essential for addressing complex physical, developmental, and psychosocial needs during rehabilitation.
- This case provides valuable data for optimizing treatment protocols for severe pediatric burns.
Abstract:
Survival of infants with greater than 80 per cent body surface area burns has not been well documented. Survival of a 4-month-old infant with 80 per cent full skin thickness flame injury is reported. Data from the National Burn Information Exchange showed that there were 2266 infants under 8 months of age treated for burns in reporting hospitals. Only four children of the 2266 were treated for full skin thickness thermal injury covering more than 80 per cent TBSA and none survived except for the child reported here. It was felt that early aggressive excision of the burn eschar was an important factor leading to the survival of this infant. Complex rehabilitation issues related to developmental issues as well as physical and psychosocial needs were identified and addressed throughout her time in hospital by a multidisciplinary team to ensure the best possible quality of life.