Related Experiment Video
Updated: Aug 2, 2026
Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children
Published on: September 11, 2018
Mortality in paediatric burns at the Women's and Children's Hospital (WCH), Adelaide, South Australia: 1960-2017
Hsu Phie Chong1, Linda Quinn1, Rebecca Cooksey1
1Department of Burns Surgery, Women's and Children's Hospital (WCH), Australia.
Insights
Pediatric burn mortality has significantly declined since the 1960s, especially for severe burns exceeding 40% total burn surface area (TBSA). Improved safety standards and medical advancements have drastically increased survival rates for children with extensive burn injuries.
Area of Science:
- Pediatric Burn Care
- Trauma Surgery
- Public Health Interventions
Background:
- Burn injuries are a leading cause of preventable childhood death globally, with scalds being the most common mechanism.
- Extensive burns, defined as greater than 40% total burn surface area (TBSA), are associated with high mortality and morbidity in children.
Purpose of the Study:
- To review mortality trends in pediatric burn patients over a 60-year period at a tertiary burns center.
- To identify local causes of mortality and guide future clinical research in pediatric burn care.
Main Methods:
- Prospective data collection of pediatric burn patients treated between 1960 and 2017.
- Analysis included patient age, gender, mechanism of injury, and TBSA, focusing on cases with TBSA of 40% or greater.
Main Results:
- Overall mortality for burns ≥40% TBSA was 34% (26/75), with a sharp decline from 24 deaths in the 1960s to fewer in subsequent decades.
- Flame burns were a significant cause of mortality, with 12 of 21 deaths attributed to clothing igniting near a flame source.
- All patients with TBSA <40% survived; average length of stay for non-survivors was 7 days.
Conclusions:
- Mortality from pediatric burns has significantly decreased, with good prognosis even for extensive injuries (>90% TBSA).
- Investigations into fabric flammability led to revised Australian children's clothing standards, contributing to improved survival.
- Advances in pediatric resuscitation, surgical techniques, and wound care have enhanced outcomes for severe burn survivors, with future research focusing on aesthetic and functional results.
Background:
Burn injuries are the third leading cause of preventable death in children worldwide, resulting in over 100 000 annual hospitalisations. In the paediatric population, scalds are the commonest mechanism and burn injuries of greater than 40% total burn surface area (TBSA) are associated with a high mortality and morbidity rate.
Aims:
The aim of this study was to review mortality in paediatric burns in a tertiary burns centre over a 60-year period, providing an understanding of local causes of mortality and directing future clinical research.
Methods:
We reviewed data collected prospectively from patients treated for burn injuries at the WCH from 1960 to 2017. Data of age, gender, mechanism of injury and TBSA were collected. TBSA of 40% and greater were included in the study.
Results:
All patients with total burn surface area (TBSA) less than 40% survived. There were a total of 75 patients who sustained burns of or greater than 40% TBSA. Overall mortality was 34% (26 of 75) of which 24 occurred in the 1960s. Of the 21 patients who died of flame burn injuries, 12 of them were described as clothes catching alight from being in close proximity to the source of flame. Average length of stay for patients who did not survive was 7 days (1-26).
Conclusion:
Mortality has since declined and the prognosis for survival good, even in TBSA of greater than 90%. The investigations in fabric flammability led by Dr Thomas Pressley and Mr Murray Clarke prompted the rewriting of Australian standards for production of children's clothing. This, in combination with advances in paediatric resuscitation, surgical techniques as well as wound care has improved survival rates and outcomes in extensive burn injuries. Future studies focus to see not only better survival rates, but also better aesthetic and functional outcomes in burn survivors.
