Bath scalds in children in the south-east of Scotland.

Scalds caused by domestic hot tap water constitute a significant but preventable hazard in childhood. We have reviewed some of the factors contributing to such injuries, and the experience of a regional paediatric burn unit in their treatment. There were 91 children with bath water scalds and 667 children with thermal injuries from other sources included in this study. In the former group, scalds were more common on the limbs, including the hands and feet. Scalds involving over 40% of body surface area were more common in children with bath water injuries; however, there was no difference between the groups with regard to hospital stay or requirement for skin grafting. Parents ran the bath responsible for scald production in most cases, but single parenthood did not appear to be a risk factor. First aid application made no significant difference to eventual burn area or hospital stay. It appears from this study that reduction of domestic hot water temperature is necessary. Statutory control is likely to offer the best solution to the problem of domestic hot tap water scalds in childhood.     

“The home,the bathroom,the taps,and hot water”: The contextual characteristics of tap water scalds in Australia and New Zealand

IntroductionScalds from hot tap water can have devastating consequences and lifelong impact on survivors. The aims of this study were to (i) describe the frequency, demographic profile, injury event characteristics, and in-hospital outcomes for people with tap water scalds admitted to Australian and New Zealand burn centres; and (ii) determine whether variation was present in the frequency and epidemiological characteristics of tap water scalds between jurisdictions.MethodsData were extracted from the Burns Registry of Australia and New Zealand for people with tap water scalds admitted to Australian or New Zealand burn centres between January 1, 2010 and December 31, 2018. Demographic, injury severity and event characteristics, surgical intervention, and in-hospital outcomes were investigated.ResultsWe included 650 people with tap water scalds admitted to Australian and New Zealand burn centres during the study period. Australians with tap water scalds (median [IQR] 29 [1–69] years) were older than New Zealanders (2 [1–36] years). Most tap water scalds occurred in the home, and 92% of these occurred in the bathroom. More than 55% of injuries occurred due to the accidental alteration of water temperature at the tap fixture. Two thirds of patients underwent a surgical wound procedure. The overall mortality rate was 3.7%, and the median hospital length of stay was 8.8 days.ConclusionTap water scalds remain a public health problem in Australia and New Zealand. Our research highlights where gaps in current heated water regulations in residential homes perpetuate risks of tap water scalds, particularly in high-risk groups at the extremes of age. Extending current heated water regulations to include all Australia and New Zealand homes is urgently needed in conjunction with design safety improvements, and ongoing education of key stakeholders.     

A Prospective study on the epidemiology of burns in patients admitted to the Harare burn units.

The purpose of this study was to record the causes and the magnitudes of burn injuries prospectively and to evaluate the outcome of treatment of patients admitted to the burn units in Harare. The median age of the 451 patients included was 6 years (range: 1 month to 71 years), 54% were female and 46% male. The burn injuries were caused by flame in 51% of the cases and hot liquids in 47%. The overall median total body surface area burnt was 13% (range: 0.5 to 99%). Parasuicidal burns (attempted suicides) were noted in 11% of the patients with a median total body surface area burnt of 30% and mortality of 73%. Lodgers were overrepresented in the material. Delayed split skin grafting was done on 26% of the patients and early primary excision and skin grafting on 3%. The overall median hospital stay was 15 days (range: 0 to 229 days). The median hospital stay for patients with delayed split skin grafting was 42 days and that for those with primary excision and split skin grafting was 17 days. The overall mortality was 22%. All patients with burns larger than 65% of the total body surface area died. Burn injuries were more frequent and larger with higher mortality in females than in males. Flame was the major cause of the burns. Self-inflicted burns, noted mainly in young women, resulted in 73% mortality. Primary excision and grafting reduced hospital stay by 60% compared to delayed skin grafting.     

A comparison of the epidemiology of isolated and non-isolated hand burns

Hand burns are common and treatment individualized, however given large volumes in some centers, pattern recognition may help optimize service provision. We performed a single center retrospective review from 2014 to 2018 of hand burns in patients aged 16 and over. Burns confined to the hands were considered isolated. We found 1163 patients (790 male, 68%), with 853 isolated (9% bilateral) and 310 non-isolated (35% bilateral) hand burns, and 12% were sustained in industrial workplaces. Most isolated burns received first aid (72%) and were scalds (41%) or contact (23%). Many presented to hospital by car (73%) and most were treated as outpatients (92%). Non-isolated burns were mainly flash (38%) or flame burns (25%, p < 0.01), with 66% given first aid, 49% used ambulances (p < 0.01) and 54% underwent hospital admission (p < 0.01). Non-isolated injuries had more full thickness involvement (p < 0.01), 13% were resuscitation burns and 10% received intensive care. Isolated and non-isolated burns are distinct clinical entities, as are unilateral and bilateral injuries. Isolated burns are usually unilateral scalds or contact burns, suited to outpatient treatment. Non-isolated burns are often flash or flame, bilateral, often needing ambulances, admission, and interventions. First aid can be improved, and consideration given to inpatient rehabilitation of bilateral hand burns.     

Epidemiology of childhood burns in the critical care medical center of Kinki University Hospital in Osaka, Japan

The objective of the present study was to describe the characteristics of pediatric burns in order to prepare a program for the prevention of severe burn injuries in children. We conducted a retrospective study of burn victims aged 15 years or younger who were hospitalized in our Critical Care Medical Center between 1982 and 1997. There were 73 children with burn injuries hospitalized in our center during the study period. The greatest number were children 1 year old. The average % body surface area burned was 21. 5+/-20.5%. The most important causes of pediatric burns were found to be hot bath water and other hot liquids. Hot bath scalds accounted for about half of the pediatric burns occurring in all age groups, and they were often extensive. Non-bath scalds accounted for about one-third of the pediatric burns and were most frequent in children 2 years and younger. All the injuries sustained at home occurred when a family member was in the house.Similar to many reports from overseas, non-bath scalds were one of the most common causes of burns in this study; however, hot bath scalds were the most important cause.These data are being used to develop a prevention program. We also consider it necessary to educate children and their family members about the dangers of burn injuries.     

Short-term respiratory outcomes of neonates with symptomatic congenital lung malformations

IntroductionThe purpose of this study was to evaluate short-term respiratory outcomes in neonates with symptomatic congenital lung malformations (CLM).MethodsConsecutive newborns who underwent surgical resection of a CLM were retrospectively reviewed. Demographic, prenatal, and outcomes data were analyzed as appropriate (p < 0.05).ResultsTwenty-one neonates were managed at a median gestational age of 36.2 weeks [interquartile range (IQR), 33.8–39.0]. Endotracheal intubation was required in 14 (66.7%) for a median of 7.5 days [interquartile range (IQR), 3.0–25.8]. Three (14.3%) children underwent ex utero intrapartum treatment-to-resection, and another 14 (66.7%) had neonatal lung resections performed at a median age of 2.0 days (IQR, 0.08–19.5 days). Excluding one patient who received comfort care at birth, all neonates survived to hospital discharge with a median length of hospitalization of 36.5 days (IQR, 23.8–56.5). More than one-quarter were discharged on supplemental oxygen by nasal cannula. Based on a median follow up of 35.5 months (IQR, 19.0–80.8), CLM-related morbidity was still evident in 55.0%.ConclusionOur study suggests a high incidence of complications and chronic respiratory morbidity after neonatal lung resection for symptomatic CLMs. These data highlight the need to provide realistic expectations in perinatal counseling discussions with families and the importance of coordinating appropriate multidisciplinary follow up for these children.Level of Evidence: Level IV.     

Military trauma care in Birmingham: Observational study of care requirements and resource utilisation

Background

The Royal Centre for Defence Medicine is located at University Hospitals Birmingham (UHB). Since 2001 all UK military casualties injured on active duty have been repatriated here for their initial treatment. This service evaluation was performed to quantify the work undertaken, with the aim of providing a snapshot of a year's military trauma work in order to inform the delivery of trauma care in both the military and civilian setting.

Methods

Military patients admitted with traumatic injuries over a 12-month period were identified and the hospital notes and electronic records reviewed. Data were collected focusing on three areas – the details of the injury, information about the in-patient admission, and surgical interventions performed.

Results

A total of 388 patients were used in the analysis. Median total length of stay was 10.5 days (IQR: 4–26, range: 0–137 days), and a median 6.0 days (IQR: 3.0–11.0, range: 1–49 days) was spent on intensive care by 125 patients. Surgical intervention was required for 278 (71.6%) patients, with a median of 2.0 operations (IQR: 1.0–4.0, range: 1–27) or 170 min (IQR: 90.0–570.0, range 20–4735 min) operating time per patient. 77% of these patients had their first procedure within 24 h of arrival. Improvised explosives accounted for 50.5% of injuries seen. Spearman rank correlation between New Injury Severity Score with length of stay demonstrated significant correlation (p < 0.001), with a coefficient of 0.640. A model predicting length of stay based on New Injury Severity Score was devised for patients with battle injuries.

Conclusion

This report of 12 months work at UHB demonstrates the service commitment to these casualties, describing the burden of care and resource requirements for military trauma patients.     

Long-term mortality outcome of victims of major trauma

Introduction

Although trauma is associated with major acute morbidity and mortality, its long-term outcome is less well defined. We sought to define the rate of readmission to hospital and long-term mortality of victims of major trauma.

Patients and Methods

All Calgary Health Region residents presenting to the regional trauma program with an injury severity score (ISS) ≥12 between April 1, 2002 and March 31, 2006 were included. Readmission to hospital within one-year and deaths occurring on or before September 30, 2008 were identified using regional and provincial databases.

Results

A total of 2652 incident major trauma episodes occurred among 2630 residents; the median age was 41.3 [interquartile range (IQR); 23.1-59.2] years, 1,915 (72%) were male, the median ISS was 19 (IQR; 16-25), and 717 (27%) required intensive care unit admission. Among 2350 survivors to hospital discharge, 537 readmissions occurred (median length of stay 4.0; IQR; 1.6-7.5 days) among 386 patients within one-year of the incident trauma episode, and 323 (60%) required surgery. Re-admitted patients were older, had higher ISS, had longer initial admission length of stay, and were less likely to have sports related injuries. Two hundred and fifteen (8%) of 2350 survivors to hospital discharge died during the median study follow-up duration of 1543 (IQR; 1181-1934) days. Case-fatality rates for 28 days, 90 days, and 365 days were 304 (11%), 327 (12%), and 370 (14%), respectively. Among survivors to 28 days (n = 2348), 66 (3%) suffered delayed one-year mortality (i.e. death occurred between 28 days and 365 days post-trauma). Age ≥65 years of age, initial hospitalisation for ≥28 days, and unintentional falls were independently associated with delayed one-year mortality.

Conclusions

Patients with major trauma are at risk for both acute and delayed adverse outcomes.     

Tap water scalds among seniors and the elderly: socio-economics and implications for prevention

INTRODUCTION: Tap water scalds among those >or=60 years old are often attributed to physical impairments with aging. This study assesses socio-economics associated with tap water scalds among seniors and the elderly. METHODS: Charts of patients admitted to an urban Burn Center between 7/00 and 6/04 for treatment of tap water scalds were reviewed. Demographics, injury details, co-morbidities, surgical interventions/critical care requirements, length of stay (LOS), disposition and related economics were reviewed. RESULTS: During the study period, 68 patients >or=60 years were hospitalized for treatment of these scalds. Mean age and burn size were 78+/-1 years and 7+/-0.9% TBSA. Over 98% of patients were admitted with pre-existing co-morbidities; 60% required ICU care for 40+/-5 days; 22% required mechanical ventilation and 71% required surgery. LOS was 34+/-4 days. Most patients received government assistance income. Pre-injury, 32% resided alone. Post-injury, 10% of patients returned home alone; mortality was 22%. Per patient hospital costs approximated $113,000. CONCLUSION: These findings report that tap water scalds result in significant morbidity, mortality and health care costs for local seniors and the elderly. Socio-economic factors play a significant role in these injuries and must be assessed when planning prevention efforts.     

Factors affecting mortality and epidemiological data in patients hospitalised with burns in Diyarbakir, Turkey

BACKGROUND: Burns continue to be responsible for significant morbidity and mortality in developing countries. In this study we aimed to determine the factors affecting mortality and epidemiological data by examining the records of burned patients. METHOD: The hospital records of 980 patients who were hospitalised in the Burns Unit at Dicle University Hospital (DUH) between June 1994 and July 1999 were examined for factors affecting mortality. Factors evaluated included gender, age, burn type, degree and extent of burn, prognosis and length of hospitalisation (LH). We investigated the relationship (if any) between the demographic data, degree and extent of burns and mortality and morbidity rates. RESULTS: The study group consisted of 325 males (33.2%) and 655 females (66.8%). Of the patients 738 (75.3%) were children (age under 15 years), 217 (22.1%) were younger adults (age 15-50 years), and 25 (2.6%) were older adults (age over 50 years). The mean age was 11.2 +/- 14.01 years (range 15 days-95 years). Of the burns 618 (63.1%) were scalds, 199 (20.3%) burns from a flame and 163 (16.6%) electrical burns. The mean extent of burn was 24.3 +/- 14.5% (range 1-95%). Seven hundred and eighty-seven (80.3%) of the study group made a full recovery, 131 (13.4%) were discharged from hospital after partial recovery, and 62 (6.3%) died. The mean LH was 11.33 +/- 8.8 days (range 1-67 days). There was a positive correlation between burn extent and mortality (r = 0.35, p < 0.0001) and between age and type of burn (r = 0.60, p < 0.0001). While scalds had the highest frequency among children, flame and electrical burns were most common in the adult and older adult groups. There was also a positive correlation between degree and type of burn (r = 0.32, p = 0.0001), scalds tending to be more superficial while flame and electrical burns were generally more serious. Deaths of patients with extensive burns usually occurred in the first 5 days following injury due to acute renal failure and hypovolaemic shock, while deaths from moderate and minor burns usually occurred after 7 days and were due to wound infection and sepsis. CONCLUSION: We found positive correlations between age and type of burn, degree and type of burn, and the extent of burn and mortality. The overall mortality rate for our unit was 6.3%.     

Acute burn care in resource-limited settings: A cohort study on treatment and outcomes in a rural regional referral hospital in Tanzania

BackgroundOnly a few papers are published on the safety and effectiveness of acute burn care in low-income countries. A cohort study was therefore carried out to determine such outcomes.MethodsThe study was conducted in a rural Tanzanian hospital in 2017–2018. All patients admitted with burns were eligible. Complications were scored during admission as an indication for safety. Survivors of severe burn injuries were evaluated for time of reepithelialization, graft take, disability (WHODAS2.0) and quality of life (EQ5D-3L) up to 3 months post-injury, as an indication of effectiveness.ResultsPatients presented on average at 5 days after injury (SD 11, median 1, IQR 0–4). Three patients died at admission. The remaining 79 were included in the cohort. Their median age was 3 years (IQR 2–9, range 0.5–49), mean TBSA burned 12% (SD10%) and mortality rate 11.4%. No surgery-related mortality or life-threatening complications were observed. Skin grafting was performed on 29 patients at a delayed stage (median 23 days, IQR 15–47). Complications of skin grafts included partial (25% of procedures) and complete graft necrosis (8% of procedures). The mean time to reepithelialization was 52 (SD 42) days after admission. Disability and quality of life improved from admission to 3 months after injury (p<0.001, p<0.001, respectively).ConclusionIn this resource-limited setting patients presented after a delay and with multiple complications. The mortality during the first two weeks after admission was high. Surgery was found to be safe and effective. A significant improvement in disability and quality of life was observed.     

Epidemiology and mortality of hospitalized burn patients in Kohkiluye va Boyerahmad province (Iran): 2002-2004

The Kohkiluye va Boyerahmad province is located in the south of Iran. The population of the province is about 615,000, living in 14,261 km(2). The total number of patients in the study was 235. There were admitted to the burn unit of Shahid Beheshti hospital (Yasuj) between 18 July 2002 and 17 July 2004. Of these patients, 149 (63.4%) were accidental and 86 (36.6%) were self-inflicted burns. The hospitalization rates for accidental and self-inflicted burns were 12.1 and 7.0 per 100,000 person-years, respectively. There is a significant difference in the sex ratio (males:females) between accidental (1.40) and suicidal (0.13) patient groups (P((2))<0.00001). The fatality rates for accidental and self-inflicted burns were 2.1 and 59.5%, respectively. The mortality rates for accidental and self-inflicted burns were 0.24 and 3.81 per 100,000 person-years, respectively. The overall mean and median ages for accidental patients were 19.4 and 13 years, and those for self-inflicted burns were 24.9 and 23 years, respectively. In the accidental patients, the BSA of the burns ranged from 5 to 95%, with a median of 15%. In the self-inflicted patients, the median of BSA was 65%. The majority of accidental burns were caused by scalds (43.2%) and of self-inflicted burns by kerosene (87.5%). The median hospital stay was 8 days with a range of 1-43 days for accidental patients. The median hospital stay was 4 days with a range from <1 to 36 days for fatal self-burning patients. In non-fatal self-burning cases, the median hospital stay was 20 days with a range of 4-53 days. There is significant difference between fatal and non-fatal self-burning cases for hospital stay (P((2))<0.0001). No definite correlation was found between the incidence of either accidental or self-inflicted burns and seasons (P((2))>0.05). Most of the burns occurred at home.     

Superiority of silver-foam over porcine xenograft dressings for treatment of scalds in children: A prospective randomised controlled trial

AimOur aim was to compare two different regimens for the treatment of children with partial-thickness scalds. These were treated with either a porcine xenograft (EZderm^®, Mölnlycke Health Care, Gothenburg, Sweden) or a silver-foam dressing (Mepilex^® Ag, Mölnlycke Health Care, Gothenburg, Sweden).MethodsWe organised a prospective randomised clinical trial that included 58 children admitted between May 2015 and May 2018 with partial-thickness scalds to The Burn Centre in Linkoping, Sweden. The primary outcome was time to healing. Secondary outcomes were pain, need for operation, wound infection, duration of hospital stay, changes of dressings, and time taken.ResultsThe patients treated with silver-foam dressing had a significantly shorter healing time. The median time to 97% healing for this group was 9 (7–23) days compared to 15 (9–29) days in the porcine xenograft group (p = 0.004). The median time to complete healing for the silver-foam group was 15 (9–29) days and for the porcine xenograft group 20.5 (11–42) days (p = 0.010). Pain, wound infection, duration of hospital stay, and the proportion of operations were similar between the groups. Number of dressing changes and time for dressing changes were lower in the silver-foam dressing group (p = 0.03 for both variables).ConclusionsWe compared two different treatments for children with partial-thickness scalds, and the data indicate that wound healing was faster, fewer dressing changes were needed, and dressing times were shorter in the silver-foam group.     

A systematic review of the features that indicate intentional scalds in children

Background

Most intentional burns are scalds, and distinguishing these from unintentional causes is challenging.

Aim

To conduct a systematic review to identify distinguishing features of intentional and unintentional scalds.

Methods

We performed an all language literature search of 12 databases1950–2006. Studies were reviewed by two paediatric/burns specialists, using standardised methodology. Included: Primary studies of validated intentional or accidental scalds in children 0–18 years and ranked by confirmation of intentional or unintentional origin. Excluded: neglectful scalds; management or complications; studies of mixed burn type or mixed adult and child data.

Results

258 studies were reviewed, and 26 included. Five comparative studies ranked highly for confirmation of intentional/unintentional cause of injury. The distinguishing characteristics were defined based on best evidence. Intentional scalds were commonly immersion injuries, caused by hot tap water, affecting the extremities, buttocks or perineum or both. The scalds were symmetrical with clear upper margins, and associated with old fractures and unrelated injuries. Unintentional scalds were more commonly due to spill injuries of other hot liquids, affecting the upper body with irregular margins and depth.

Conclusions

We propose an evidence based triage tool to aid in distinguishing intentional from unintentional scalds, requiring prospective validation.     

Major trauma associated with mobility scooters: An analysis of the trauma audit research network

AimsTo establish the incidence and nature of injuries seen in patients following mobility scooter incidents.MethodsThe Trauma Audit and Research Network (TARN) database was used to collect data concerning injuries associated with mobility scooters. The data was taken from incidents that occurred between February 2014 and November 2020. The data analysed included: patient demographics, injury mechanism and patterns and associated mortality rates.Results1,504 patients were identified of which 61.4% were male. The median age was 76.2 years (IQR 63.5–84.9). The median injury severity score (ISS) was 9 (IQR 9–17), with major trauma (ISS ≥16) being observed in 29.4% of patients. Injuries to the limb were most common, although injuries to the head were most severe. Vehicle collisions accounted for 65.4% of injuries and were most closely associated with the most severe incidents. The median length of stay in hospital was 12 days, excluding the patients who died. Overall, mortality following injury was 10.6%, but the mortality rate was 15.4% in those aged 75 years and over, and 24.2% in those sustaining severe trauma.ConclusionAs the population ages, injury characteristics of those with both major and non-major trauma changes. Mobility scooter use is prevalent amongst older people, and we provided a detailed analysis of injuries sustained with their use across a national database. The length of stay and the inherent resource use, because of admission following mobility scooter trauma, is considerable. These injuries particularly affect the ‘most elderly’ and carry a considerable mortality burden.     

Laparoscopic restoration of intestinal continuity (the LapRICon procedure): a safe and feasible technique for restoration of transanal defecation

Background

The restoration of intestinal continuity after open abdominal surgery can be technically challenging. The authors describe their experience with the laparoscopic approach to attempted reversal for patients with an exteriorized intestine.

Methods

A consecutive series of patients under the care of a single surgeon (D.B.) underwent laparoscopic restoration of intestinal continuity (LapRICon). All the patients first underwent exclusion of intraabdominal sepsis with computed tomography (CT) scanning and then preoperative localization of proximal and distal bowel ends via water-soluble contrast studies. Stomal sites were used for initial access, establishment of capnoperitoneum, and formation of anastomoses extracorporeally. All adhesiolysis and mobilization of bowel ends were performed intracorporeally. Pre-, intra-, and postoperative data were collected for all the patients. Return of intestinal function, overall hospital length of stay, and postoperative complications were collected. Nonparametric statistics were used to analyze the data.

Results

A total of 13 patients (6 women) were followed up for 9?months (interquartile range [IQR], 5–16?months). The median age of the patients was 39?years (IQR, 28–64?years). Nine patients were categorized as American Society of Anesthesiology (ASA) class 1. One patient was ASA 2, and the remaining patients were ASA 3. The median colorectal physiologic and operative severity scores for the enumeration of mortality and morbidity (CR-POSSUM) were 0.68 (IQR, 0.68–1.72). The intraoperative blood loss was minimal (median 30?ml; IQR, 20–125?ml). The median operative duration was 240?min (IQR, 180–240?min), and a median of 4 ports (IQR, 3–5 ports) were used. Enterocolonic anastomoses were fashioned in six patients, enterorectal anastomoses in two patients, and enteroentero anastomoses in three patients. A single patient had multiple anastomoses. The median time to return of intestinal function was 5?days (IQR, 3–13?days), and the overall hospital stay was 8?days (IQR, 5–24?days). Four complications (25%) (2 recurrent fistulas, 1 anastomotic leak, and 1 open conversion) occurred in this series of patients.

Conclusions

The LapRICon procedure is a feasible technique with acceptable morbidity. Several principles and techniques are described to aid the surgeon who wishes to embark on use of such a technique.     

Epidemiology and mortality of burns in a general hospital of Eastern Sri Lanka

This 2-year prospective study examined the epidemiology and mortality of 345 patients admitted with burn injuries. Sixty-four percent of all burns were accidental in nature and at least 25% were self-inflicted. The rest were due to assaults or had a doubtful cause. The median age was 22 years. Forty-one percent of the accidents were due to the fall of a homemade kerosene bottle lamp. The main cause was flames, followed by scalds. Females outnumbered males in all categories of burns except cases of assault, and suffered from a higher mortality. Most at risk of accidental burns were children between 1 and 4 years, who suffered primarily from scalds. Self-inflicted burns were most common among women aged 20–29 years. The overall median total body surface area (TBSA) burned was 16%. Self-inflicted and ‘doubtful’ burns were much more extensive and more often fatal than accidental ones. The overall mortality rate was 27%. Burns involving more than 50% of the body surface area were invariably fatal. Mortality was highest in the elderly and in the 20–29 years age group. Burns were the first single cause of mortality in the surgical wards. The case is made for the establishment of more Burns Units.     

Bath-water scalds in children and thermostatic mixer valves

BACKGROUND: Scalds in children caused by hot bath-water have been virtually eliminated in countries where thermostatic mixer valve (TMV) devices have been introduced. We aimed to determine the frequency and severity of these injuries in our region and estimate reduction in workload and cost if TMVs were introduced in the future. METHODS: A retrospective review was conducted of case-notes for all bath-water scalds patients aged under 16 years, admitted to the Northern Regional Burn Centre from the 1 January 1997 until 1 January 2005. RESULTS: One hundred and twenty-five patients were admitted over this period. Their average+/-S.D. age was 35.7+/-27.23 months. Scalds ranged from 0.5 to 45% total burn surface area (mean 9.3+/-9.15%). These patients stayed in hospital for an average of 6.3+/-5.58 days and 18 (14.4%) required tangential excision and split skin grafting. DISCUSSION: These injuries are: painful, psychologically disturbing and potentially preventable. The care of these children has significant cost implications, which could be reduced with the introduction of proposed legislation to enforce the installation of TMVs into all newly built houses. We are in favour of such legislation to prevent any further unnecessary suffering and cost arising from these accidents.     

Epidemiology of hospitalized burns patients in Taiwan

Previous studies based on either single hospital data or sampling of specific groups of hospitalized burns victims in Taiwan have provided only minimal epidemiological information. The study is designed to provide additional data on the epidemiology of hospitalized burns patients in Taiwan. Data were obtained from the Burn Injury Information System (BIIS), which brings together information supplied by 34 contracted hospitals. The study time course spanned a 2-year period from July 1997 to June 1999. Patient characteristics (age, sex, education level, etc.), causes and severity of injuries, and medical care measures were explored. A total of 4741 patients were registered with BIIS over the study period. The majority of hospitalized patients (67%) were male. The age distribution of burns patients showed peaks occurring at the age groups of 0-5 and 35-44 years. Over the time course of a day, burn injuries occurred more frequently from 10:00 to 12:00 h and 16:00 to 18:00 h. Injuries suspected as the result of suicide, homicide or child abuse accounted for 4.8% of hospitalized cases. More than 48% of the burns occurred in the home. The leading type of burn injury was scalding, followed by naked flame, explosion, electrical burns, and chemical burns due to caustic or corrosive substances. The mean percent total body surface area (%TBSA) for adults was 19%, and for young children was 12%. The average length of hospital stay was 18 days. In conclusion, children under 5 years and adults between 35 and 44 years of age are two high-risk groups for burn injuries. Corresponding to meal preparation time, hot substances such as boiling water, hot soup, etc. are the most common agents responsible for scalds. Prevention programs for reducing the risk of burn injuries during cooking and eating are required, especially for parents with young children.