Pediatric Department experienced in child burns treatment (10 years)

Abstract

Introduction. The treatment issue of children with thermal traumas is a debated topic even to this day. According to the Department of Burns and Plastic Surgery data, the burns make up 5% to 6% of all acute pediatric traumas. Thermal lesions, depending on the complications that developed and their severity, are divided into: flame burns (14.2 %); burns through contact with hot solids (9.6%); electric burns (3.4%); Though the majority is caused by hot liquids (72.8%). Aim of study. Research of the results of management and treatment of children with thermal injuries, in the Department of Burns and Plastic Surgery in Republic of Moldova. Materials and methods. During the past 10 years (2007-2017) in the Department of Burns and Plastic Surgery, there were treated 5715 children with burns (0-3 years 50.6%, 4-7 years 24.4%, 8-18 years 25%). Superficial burns -2844 (55.2%). Deep burns – 2871 (44.8%). Patients hospitalized with burn shock (S>15% TBSA) – 645 children. Surgical treatment (excisional debridement of the burn, autodermoplasty, limb amputation) – 2820 children with thermal lesions. Results. Respecting certain phases in the system, when providing medical assistance to burned children, allowed avoiding any severe complications, decreased the death rate and post burn disabilities. Evacuation of burned children with thermal lesions in critical conditions is done in the first 2-3 hours after the trauma, and implies anti-shock treatment at the trauma site and during transportation. Information about the burned children is received through Sanitary Aviation non-stop. It offers the possibility of movement of the consultant doctor to the trauma site. The accumulated experience indicates, that the beginning of intensive care at an early stage (adequate thermal shock therapy, septic complications prophylaxis, early surgical reconstruction of affected skin) allows the obtaining of positive results in this surgical pathology. Mortality review in ten years (2007-2017) (0.15; 0.5; 0; 0.28; 0; 0.24; 0.12; 0.11; 0; 0;) shows the dynamics and the tendencies of the treatment process in Pediatric Burns Department. Conclusions. Moderately positive results in the burned children treatment depends on rational tactics: Fast evacuation of the child with severe thermal lesions in to the specialized unit (Department of Burns) during the first few hours of the acquired injury; • Anti-shock treatment during transportation; • Guarantee of primary conditions for effective treatment in the Burns Department; • 2 intensive care wards; • Up-to-day surgical devices (necrotomes, electric dermatomes, perforators, electro coagulators); • Non-stop access to blood, blood components, skin substitutes; • The most efficient burns “treatment method” is prophylaxis; • Statistics shows that due to prophylaxis the incidence of burns in the Republic of Moldova decreased up to 20 %.