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Post burn pruritus in pediatric burn patients
Sophie Maria Pierrette Nieuwendijk1, Iris Johanne de Korte1, Mereille Marren Pursad2
1Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Pediatric Surgery, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Insights
Post-burn pruritus affects over 70% of pediatric patients, with deeper wounds and larger burn areas increasing severity. Current treatments offer limited relief, highlighting a need for better pediatric burn care strategies.
Area of Science:
- Pediatric Burn Care
- Dermatology
- Wound Healing
Background:
- Pruritus (itching) is a common and distressing symptom following burn wound healing.
- Limited research exists on pediatric burn pruritus, necessitating specific investigation in this age group.
Purpose of the Study:
- To determine the incidence and severity of pruritus in pediatric burn patients.
- To identify predictors associated with post-burn pruritus in children.
- To evaluate the effectiveness of pharmacological treatments for pediatric burn pruritus.
Main Methods:
- Prospective observational study design.
- Utilized numeric rating scale and Itch Man Scale for pruritus assessment.
- Employed Fisher exact and Kruskal-Wallis tests for predictor analysis.
Main Results:
- Pruritus was reported in 71.7% of 413 pediatric patients.
- Significant predictors included time since burn, injury depth, Total Surface Area (TBSA) burned, and skin grafting.
- Only 29.8% of patients using medication achieved complete symptom relief.
Conclusions:
- Post-burn pruritus remains highly prevalent in pediatric burn care.
- Pruritus intensity and frequency are exacerbated by deeper wounds, larger TBSA, and occur more frequently within the first three months post-burn.
Background:
Pruritus is a common problem seen in the healing process of a burn wound and gives great discomfort for the patient. Most research in this field has been done in the adult population, so evidence in the pediatric population is still lacking PURPOSE: The aims of this study were to assess the incidence and severity of post-burn pruritus, identify predictors for pruritus and evaluate the pharmacological treatments in a pediatric setting.
Methods:
Pruritus was assessed in this prospective observational study using a numeric rating scale and the Itch Man Scale applied by the patients' caregiver. The predictive values of candidate predictors for pruritus were compared using Fisher exact tests and Kruskal-Wallis tests.
Results:
413 patients were included in this study. Pruritus was reported in 71.7% of the patients. Complete symptom relief was only achieved in 29.8% of the patients who used medication. Time since burn (p<0.001), depth of the injury (p=0.017), TBSA burned (p=0.001) and skin grafting (p=0.001) were found to be significant predictors for post-burn pruritus.
Conclusion:
Post-burn pruritus is still a highly prevalent problem in pediatric burn care. Its intensity and frequency are higher especially in the first three months or with a deeper wound or a higher TBSA.
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