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Hand Involvement and Its Association with Burn Characteristics, Surgical Management, and Length of Stay in Paediatric
Lachlan James Madge1, Lisa J Martin2,3, Emma Catherine Mill4,5
1University of Western Australia Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA 6009, Australia.
Insights
Children with hand burns were younger and had fewer complications, but their initial hospital stay was not longer than those without hand injuries. Further research is needed on long-term outcomes.
Area of Science:
- Pediatric Burn Care
- Surgical Management
- Epidemiology
Background:
- Hand burns are a critical factor for referral to specialized burn centers.
- Limited research exists on pediatric hand burn characteristics and outcomes.
- This study addresses the gap in understanding pediatric burn epidemiology, surgical management, and length of stay based on hand involvement.
Purpose of the Study:
- To compare demographic profiles, burn injury characteristics, and clinical management of pediatric patients.
- To analyze three groups: hand-only burns, hand and other site burns, and non-hand burns.
- To investigate the impact of hand involvement on clinical outcomes in pediatric burn admissions.
Main Methods:
- Cross-sectional study of pediatric burn admissions over a 10-year period (July 2012 - June 2022).
- Descriptive statistics and univariate regression were used for group comparisons.
- Multivariate log-linear regression analyzed the association between hand involvement and length of hospital stay, controlling for confounders.
Main Results:
- Children with isolated hand burns were younger, had smaller %TBSA, and were more likely to have contact/friction burns.
- These patients also had a higher likelihood of undergoing skin grafting procedures.
- Hand involvement was not found to be an independent predictor of initial length of hospital stay.
Conclusions:
- Pediatric patients with hand burns did not experience longer initial hospital admissions compared to those without hand involvement.
- The findings suggest that initial length of stay is not significantly impacted by hand burns alone.
- Further investigation is required to understand the long-term consequences of pediatric hand burns.
Background:
Hand burns are a key criterion for immediate referral to tertiary burn centres in Australia, New Zealand, and internationally, yet few studies have examined how paediatric burn epidemiology, surgical management, and length of stay (LOS) differ according to the extent of hand involvement. The objective of this study was to describe and compare the demographic profiles, burn injury characteristics, and clinical management between three groups: children with (1) burns involving only the hands, (2) burns involving the hands and other sites, and (3) burns not involving the hands who were admitted to the paediatric Burns Service of Western Australia (BSWA) over a 10-year period.
Methods:
This cross-sectional study included all burn admissions to the state paediatric burn unit between July 2012 and June 2022. Descriptive statistics and univariate regression used to compare groups. A multivariate log-linear regression model was used to assess the independent association between hand involvement and length of hospital stay, adjusting for identified confounders. T Results: Children with burns isolated to the hands were younger, had a smaller percentage of total body surface area (%TBSA), were more likely to have sustained contact or friction burns, and were more likely to undergo skin grafting procedures compared to those with burns involving the hands and other sites, and those with burns not involving the hands. Despite these differences, hand involvement was not identified as an independent predictor of initial LOS.
Conclusion:
Paediatric patients with hand burns did not have longer initial hospital admissions than those without hand involvement. Future research needs to assess longer term impacts of hand burns.
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