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Wound infection among children with moderate burns - An explorative review of the association between reported
Matilda Karlsson1, Åse Östholm Balkhed2, Ingrid Steinvall1
1Department of Hand Surgery, Plastic Surgery and Burns, Linköping, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Insights
Burn wound infection (BWI) diagnosis criteria are highly variable, complicating comparisons. High BWI rates in Swedish children may stem from close monitoring or lenient diagnostic thresholds, not necessarily increased infections.
Area of Science:
- Pediatric Burn Care
- Infectious Disease Epidemiology
Background:
- The Linkoping burn centre reported high burn wound infection (BWI) frequencies in scalded children, contrasting with international data.
- This discrepancy is notable given Sweden's high-income status.
Purpose of the Study:
- To investigate potential reasons for the elevated BWI frequency in children treated at the Linkoping burn centre.
- To compare BWI diagnostic criteria used in Sweden with those in international studies.
Main Methods:
- A literature search of PubMed Central identified studies reporting BWI frequency in pediatric burn populations.
- A retrospective analysis of children diagnosed with infection at the Linkoping centre was conducted.
Main Results:
- 47% of reviewed publications lacked defined BWI diagnostic criteria, and nearly a third did not report wound culturing.
- Retrospective analysis at the center did not confirm a decrease in infection frequency, despite diagnostic variations.
Conclusions:
- Inconsistent reporting of BWI diagnostic criteria hinders interpretation and comparison of study results.
- High BWI rates may be influenced by factors such as intensive monitoring, non-sterile dressing techniques, or low diagnostic thresholds.
Introduction:
The Linkoping burn centre in Sweden has, even though being a high income country, reported high burn wound infections (BWI) frequencies in scalded children compared to similar populations in other parts of the world.
Aim:
The aim was to investigate possible explanations for differences in frequency of BWI among children with partial thickness burns treated at the Linköping burn centre in Sweden, and that reported in other studies.
Method:
In order to investigate what BWI criteria that were used in similar studies a literature search on PubMed Central was done along with a retrospective analysis of children previously diagnosed as infected to confirm or reject the high infection frequency reported earlier.
Result:
Of the 34 selected publications reporting on BWI frequency 16 (47%) did not define a criteria for the BWI diagnosis and almost a third did not report on wound culturing. Of those who did report the use a third do not mention any bacterial growth found is these cultures. The retrospective analysis on children at the centre did not show any decrease in infection frequency even with some disagreement on onset for the BWI.
Conclusion:
The reporting of criteria and diagnosis of burn wound infection is highly variable making it difficult to interpret results and come to conclusions. The high frequency of BWI at the centre might be a result of close monitoring due to study participation, use of clean instead of sterile routine at dressing changes or low thresholds for the diagnosis in respect to changes in infection markers.
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