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Pruritus in the Pediatric Burn Population
Jennifer Zuccaro1, Diandra Budd1, Charis Kelly1
1Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Postburn pruritus affects 37.3% of pediatric burn patients. Larger burn size, older age, fire-related injuries, and deeper burns predict its occurrence, guiding targeted treatments.
Area of Science:
- Pediatric Burn Care
- Dermatology
- Quality of Life Research
Background:
- Postburn pruritus significantly impacts patient quality of life.
- Research on pediatric postburn pruritus is limited, creating a knowledge gap.
Purpose of the Study:
- To determine the incidence of pruritus in pediatric burn patients.
- To identify predictive factors for postburn pruritus in children.
- To document commonly used treatments, including laser therapy.
Main Methods:
- Retrospective analysis of pediatric burn patients (2009-2017).
- Inclusion criteria: patients treated at a pediatric burn center.
- Outcome measure: presence or absence of pruritus post-burn.
Main Results:
- 1,783 patients analyzed; 37.3% experienced pruritus.
- Predictors identified: Total Body Surface Area (TBSA) burned, age >5 years, fire/flame burns, and burn depth.
- Treatments included antihistamines, gabapentin, massage, pressure garments, and laser therapy.
Conclusions:
- This study provides crucial data on pediatric postburn pruritus incidence and predictors.
- Findings aid in identifying at-risk children for early intervention.
- Contributes to understanding and managing pruritus in pediatric burn survivors.
Abstract:
Postburn pruritus is a significant issue that can have a devastating impact on patient quality of life. Despite its known negative impact, few studies have focused on the pediatric population. Thus, the aim of this study was to determine the incidence of pruritus among pediatric burn patients as well as identify its predictive factors and commonly used treatments, including the novel use of laser therapy. A retrospective analysis of all burn patients treated at our pediatric burn center from 2009 to 2017 was conducted. The primary outcome measure was the presence or absence of pruritus at any point following the burn. One thousand seven hundred and eighty-three patients met the inclusion criteria for this study. The mean age at injury was 3.67 years (SD = 4.02) and the mean burn TBSA was 3.48% (SD = 4.81) with most burns resulting from scalds (66%). In total, 665 patients (37.3%) experienced pruritus. Following multivariable logistic regression, TBSA, age >5 years, burns secondary to fire/flame, and burn depth, were identified as significant predictors of pruritus (P < .05). Pruritus was treated with diphenhydramine (85.0%), hydroxyzine (37.3%), and gabapentin (4.2%) as well as massage (45.7%), pressure garments (20.0%), and laser therapy (8.6%). This study addresses the knowledge gap in the literature related to postburn pruritus among pediatric patients and includes one of the largest patient cohorts published to date. Moreover, the results further contribute to our understanding of postburn pruritus in children and may help us to predict which patients are most likely to be affected, so that treatment can be initiated as soon as possible.
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