Ethiology of thermal burns in children

Abstract

Bums represents one of the most difficult surgical pathologies in children and include some serious injuries with skin necrosis, fat tissue, muscles, tendons, nerves, blood vessels, bones, with a very dynamic deployment according to the stages, comprising the major symptoms of dehydration, hypoxia, anemia, metabolic disorders, endotoxicosis, immune collapse, septic complications, acute multiorganic failure syndrome. According to the Republican Center’s for Thermal Injuries statistics, bums in children represents about 5-10% of all acute injuries in children. More than half (64.5%) of children with thermal injuries are nursery and preschool age (1-5 years). But according to severity, complications and disability degree bums are situated as follow: electric bums (3.5-4%), by flame (14.2%), by contact with incandescent solids (8.7%). In most cases bums were caused by hot liquids (72.8%). The present study was conducted by Bums and Plastic Surgery Clinic of the Clinical Republican Hospital for Children "Em.Cotaga" over the past 10 years. Analyzing the evolution of trauma in 4864 children aged up to 18 years, we have elucidated the incidence, nature of deterioration, and bums complications. After etiology factors: bums with hot liquid, overheated steams - 2682 (55.1%), bums by flame or by electric flame - 1182 (24.3%), bums by incandescent bodies - 835 (17.2%), electrical bums - 262 (5.4%), chemical bums - 36 (0.7%), solar bums - 49 (1.0%). According to the depth of the bum: superficial bums (I-II-IIIA) - 2160 (44.2%), deep bums (IIIB to IV) - 2704 (55.8%). Complications: thermal shock was found in 26% of all traumatized children, septic complications - manifested by septic shock, destructive pneumonia, myocarditis, hepatitis, nephritis and toxic encephalopathy were detected in 6.4% of hospitalized patients. Location: The most frequent location of bum are upper limbs, the head -72.5%, on the 2nd place were placed patients with facial, neck and torso bums, - 48%, the lower limbs have 26% of all trauma patients, but for this location the most serious bums are characteristic. Bums in children represent some serious injuries with skin necrosis, fat tissue, muscles, tendons, nerves, blood vessels, bones, with a very dynamic deployment according to the stages, comprising the major symptoms of dehydration, hypoxia, anemia, metabolic disorders, endotoxicosis, immune collapse, septic complications, acute multiorganic failure syndrome. Children’s body with its anatomical and physiological specific and immature mechanisms of immune protection, respond inadequately to stress induced by the thermal injury that is why the evolution of the burned disease in children has characteristic and specific adaptive-compensatory mechanisms, which can generate a systemic inadequate response.