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Conservative treatment of 725 burned children hospitalized in 10 years
Insights
Conservative treatment for pediatric burns, including daily baths with chlorhexidine and silver sulphadiazine dressings, is effective. This approach minimizes risks and is suitable for children, even with slightly longer hospital stays.
Area of Science:
- Pediatric Burn Care
- Wound Management
- Infectious Disease Control
Background:
- Over a decade, 725 children were admitted to Brugmann University Hospital's pediatric burn unit.
- Most patients were under 5 years old with scalds affecting less than 10% of body surface area.
- Accurate burn depth assessment upon admission was challenging.
Purpose of the Study:
- To evaluate the efficacy of a conservative treatment protocol for pediatric burns.
- To assess the incidence of wound contamination and the need for systemic antibiotics.
- To compare hospitalization duration and iatrogenic risks associated with conservative versus aggressive treatment.
Main Methods:
- Daily baths with chlorhexidine and silver sulphadiazine dressings were administered.
- A conservative treatment approach was adopted due to difficulties in assessing burn depth.
- Systemic antibiotic administration was reserved for cases of repeated contamination.
Main Results:
- Wound contamination occurred in 80% of burns larger than 20% body surface area.
- Only 2.4% of patients required systemic antibiotics for repeated contamination.
- No fatal cases of septicaemia were observed.
- Mean inpatient time varied from 16 days (ungrafted) to 69 days (grafted >20% burns).
Conclusions:
- Conservative burn management in children, despite potentially longer hospitalization, offers lower iatrogenic risks.
- The protocol involving chlorhexidine baths and silver sulphadiazine dressings effectively managed pediatric burns.
- This approach is justified by reduced risks of anesthesia and donor site morbidity.
Abstract:
Seven hundred and twenty-five children were hospitalized in the paediatric burn unit of Brugmann University Hospital during the past 10 years. The majority of the patients were under 5 years of age and presented with scalds on less than 10 per cent of the body surface area. As burn depth was difficult to assess on admission, a conservative form of treatment was performed including a daily bath containing chlorhexidine and silver sulphadiazine dressings. Contamination of the wounds was observed in 80 per cent of the larger than 20 per cent surface burns but only 18 cases (2.4 per cent) of the series needed administration of systemic antibiotics for repeated contamination. No lethal septicaemia was observed. Mean inpatient time ranged between 16 days for ungrafted patients to 69 days for over 20 per cent surface grafted patients. The lower iatrogenic risks (anaesthesia and donor site morbidity) seemed important enough to justify conservative treatment in children despite a slightly longer hospitalization time.