Epidemiology of childhood burn injuries in Fars province, Iran.

Childhood burn injuries are a major environmental agent responsible for significant morbidity and mortality in Iran. Thus, the objective of this study was to analyze the epidemiology and current causative factors of hospitalized burn injuries among the approximately 1.6 million children between the ages of birth through 15 years residing in the Fars province of Iran. These data will be used as a basis for developing a targeted preventive program to protect children from burns. Epidemiologic data for 760 children, aged 0 to 15 years, admitted to the two burn centers of Shiraz University of Medical Sciences, over a 4-year period, 1994 to 1998, were collected and analyzed. The overall hospitalization rate was 11.8 per 100,000 person-years (PY). The sex ratio (boys/girls) was 1.38. About 60% were children aged 7 years or younger. Children aged 2 years had the highest burn incidence rate (36.9/100,000 PY). A total of 77.4% of the children had body surface area burns less than 40%. Scalds accounted for 46.2% of the burns, whereas 42.9% were caused by flame. Most of the burn injuries occurred at home (93%). There were 31 burns from suicide attempts among children aged 11 to 15 years (1.4/100,000 PY), showing a major public health problem for these children in our society. During the period of the study, 131 children died of the consequences of burns (2/100,000 PY). The epidemiology of childhood burn injuries in the Fars province is similar to that reported in other economically developing countries. It is suggested that a public health education campaign on this issue would help to reduce the incidence of childhood burn injuries in this region.     

A seven-year burn unit experience in Kayseri, Turkey: 1996 to 2002

A retrospective multifactorial epidemiological study of 742 patients admitted to Erciyes University Medical Faculty Burn Unit during a 7-year period between 1996 and 2002 is presented. The overall male-to-female ratio was 1.88:1. The highest-risk age group of burn injuries was 0 to 6 years (48.6%), with the greatest number of injuries occurring to children who were 2 to 3 years of age. Seasonal variations had no influence on the increased number of admissions to the burn unit. Scalding was the major cause of pediatric burns. Flame burns were the most frequent cause of burns in adults and the second-leading cause in children. Seventy-eight of the 742 patients died, with a mortality rate of 7.8 % in children and 12.6% and 19.23% in adult males and females, respectively. The overall mortality rate was 10.5%.     

Pediatric upper extremity burns: outcomes of emergency department triage and outpatient management.

Pediatric upper extremity burns are common. Though current American Burn Association guidelines recommend burn unit referral for burns involving the hands or major joints, many minor injuries are treated in the emergency department (ED) or outpatient setting. Despite the large number of burn patients managed by primary care providers, no large studies have been performed to assess effectiveness. A retrospective 5-year review of the epidemiology and outcomes associated with pediatric upper extremity burns treated at an urban ED was performed. Two hundred sixty-nine patients were identified. The mechanism of burn, percentage of total body surface area (%TBSA) affected, plastic surgery consultations (for wound management recommendations and additional treatment), complications, and surgical interventions were examined. Mechanisms of burn included direct contact (47%), scald (29%), flame (12%), electrical (10%), and friction or chemical (1.5%). Fifty percent of patients suffered from burns over less than 1% TBSA; close to 95% had burns on less than 5% TBSA. Seventy-five percent of patients had second-degree burns, 21% had first-degree burns, and 2% had third-degree burns. Forty patients (15%) had a plastic surgery consult. Seven patients (3%) required skin grafting. Complications occurred in five (2%) patients and included two cases of hypertrophic scarring; two patients with flexor contractures, one case of compartment syndrome requiring fasciotomy, and one late infection. These results suggest that although significant burns are usually cared for in specialized burn centers, the majority of childhood burns to the upper extremity are relatively minor and often treated in the primary care setting. Most patients had small areas of injury and healed without complications. Contact burns are an ever-increasing proportion of childhood burns and should be seemingly preventable. Education to parents and primary care physicians should be reemphasized. It appears that minor upper extremity burns treated by our urban ED staff are handled appropriately and result in favorable outcomes.     

A descriptive summary of New Jersey's 1985 burn population

Data obtained from the New Jersey State Department of Health on the 1985 hospitalized patients with burns and data collected from the National Burn Victim Foundation's standard burn reporting form were analyzed to gather information about the epidemiology of burns. Children (0 to 4 years of age) continue to be the largest percentage of the 0- to 18-year-old age group who sustain burn injuries, and 67% of those injuries are sustained by children under the age of 5. Males accounted for 69% of the total burn population; 58% of admissions were white; 69% of patients were admitted for partial-thickness burns, and 31% were admitted for full-thickness burns; the largest primary payer was third-party payers; and 92% of patients with burns were discharged to home or self-care. Data were also analyzed by examination of selected age groups to determine individual needs of specific groups. An analysis of burn injuries reported to the National Burn Victim Foundation confirmed previous reports that the home is the most likely place for a burn injury to occur and that flame and scald injuries predominate; scald injuries comprise 50% of all sustained burns. Gasoline vapors accounted for 54% of burn injuries caused by flames. The data supported efforts to develop programs that address the needs of the urban child, the 17- to 19-year-old age groups, and the elderly. The information that was collected served to redefine objectives for burn prevention programs.     

Scald burns in young children--a review of Arizona burn center pediatric patients and a proposal for prevention in the Hispanic community.

Arizona Burn Center staff observed an increasing number of pediatric scald burn admissions. Therefore, a retrospective study was conducted to identify scald demographics and etiologies. Focus groups were subsequently conducted to determine burn prevention knowledge in the target community. Arizona Burn Center scald admission variables (ages 0-5 years) reviewed included age, sex, ethnicity, TBSA, body parts burned, occurrence month and location, caregiver present, child and caregiver activities when injured, payor source, length of stay, parental language, and zip code. High-risk zip code area focus groups were then conducted. There were a total of 170 pediatric patients, aged 0 to 5 years, admitted to the burn center during 2005 to 2006. Of this total, 124 of the patients were admitted for scald burns, accounting for 59% of all pediatric burn admissions. Scald burn patient's demographics included male (52%), female (48%) with a mean age of 1.7 years. Majority ethnicity was Hispanic (63%). The mean TBSA was 8% with mean length of stay of 8 days. The remaining pediatric admissions for children aged 0 to 5 were for burns caused by fire or flame 15%, contact with a hot object 13%, friction burns 7%, chemical burns 3%, and electrical burns 3%. Demographics for the combined etiologies included an identical sex breakdown with male (52%) and female (48%). The majority ethnicity in the nonscald group was also Hispanic at 59% with a mean length of stay of 7 days and an average TBSA of 9.5%. Main etiologies of scald burns included hot water (25%), soup (24%), and coffee or tea (21%). Most common child behaviors were pulling hot substance from stove (24%), from countertop (13%), and having liquid spilled on them (13%) typically while caregiver was cooking. Mean TBSA was 8% with mean length of stay (8 days). Scalds occurred in the kitchen (83%) and mainly in child's home (94%). Mother was primary caregiver (78%). Payor source was Medicaid (86%) and the average admission cost was dollars 60,075. Only 36% of parents spoke Spanish as their primary language. Scalds (43%) usually occurred during year's first quarter (P < .001). Focus group participants (85%) reported receiving no prior burn prevention education and preferred to receive prevention instruction in small groups through established community agencies. Results suggest that culturally sensitive, bilingual scald prevention education, targeting Hispanics, is needed to create awareness of the frequency, severity, and danger associated with pediatric scalds.     

Pediatric soup scald burn injury: etiology and prevention.

One of the leading causes of scald burn injury in children is from hot soup, particularly prepackaged instant soups. The purpose of this study was to determine the demographic, socioeconomic, and situational factors that contribute to the incidence of scald burns in children. A 20-item questionnaire was given to the caregiver of children who were treated for scald burn injury at a pediatric burn center from July 2006 to March 2007. Questions included demographics (child age, gender, siblings, ethnicity), socioeconomic status (income, education), factors contributing to the injury (type of soup, child supervision, type of container), and location of injury. The mean age of the 78 children sustaining burn injury and completing the survey was 4.8 +/- 0.6 years. The majority of patients were girls (51%), and the most frequently involved ethnic group was Hispanic (44%). Households had a mean of 3.0 +/- 0.3 children in residence, and an income of less than $29,000/year (59%). The highest educational level achieved was high school for 73% of the parents. Prepackaged soup (65%) with a narrow base heated directly in the original container (46%) using the microwave (51%) was implicated in the majority of burns. Soup scald burns, especially from prepackaged instant soups, appear to predominate in lower income families with multiple children. The majority of injuries occur when the caregiver heats the soup in the original container using the microwave. Prevention of these types of injuries will require a two-pronged approach: educating families with multiple children and changing the soup packaging.     

Cement-related injuries: review of a series, the National Burn Repository, and the prevailing literature.

The spectrum of cement-related injuries encompasses contact dermatitis, abrasions, ulcerations, chemical burns, and burns from explosions during the manufacturing process. The purpose of this study was to compile cement-related conditions seen in two burn units (1999-2005), literature case reports and series (1950-2006) and the (1989-2001) National Burn Repository (NBR). There were 3597 admissions in two Midwestern burn units, of which 12 cases (0.8%) were cement burns. They occurred in men, aged 15 to 64 years with a burn range of 0.25 to 10% TBSA, exposure time of 1 to 6 hours, treatment delay of 1 day to 2 weeks, hospitalization (2-14 days). Literature review of 109 cases indicated that cement-related injuries were predominantly seen in men, aged 26 to 45 years; with a cement-exposure time of 1.5 to 4 hours, treatment delay (1 day to 5 weeks), hospitalization (10-33 days), and healing time (2-7 weeks). There were 52,219 burn admissions in the NBR, of which 44 (0.08%) were cement-related burns; 95% were men with a mean age of 41 years, 6% TBSA cement burn and an 8-day hospital stay. The demographic characteristics of the burn units and NBR cases were similar to those in the literature. This preventable injury occurred primarily in the working age male patient and was associated with long healing times. Public awareness and enhanced manufacturer package warnings and education may decrease future cement-related injuries.     

Burns caused by automobile radiators: a continuing problem.

In spite of the fact that injury warning labels have been placed on radiator caps for the last 15 years, automobile radiator scald burns continue to be a burn prevention problem. The temperature of radiator fluid may be as high as 100 degrees F to 250 degrees F in a properly functioning car and higher in an overheated vehicle. From 1974 to 1990, 100 patients with burns that were caused by automobile radiators have been admitted to the Parkland Memorial Hospital Burn Unit (1.5% of acute admissions). Eighty-two percent of the injuries occurred in the summer months, and 93% of the patients were male. Mean age was 31 +/- 17 years (range, 8 months to 79 years), and mean burn size was 11.3% total body surface area (TBSA) (range, 1% to 32%) with a mean full-thickness burn size of 0.6% TBSA. Length of stay was 7 +/- 7.4 days (range, 1 to 38 days). Burns to the face, neck, and trunk necessitated most admissions. Although there were no deaths, five patients required intensive care for airway monitoring; mean length of stay was 6 days. One patient required endotracheal intubation for a total of 11 days. Ten patients required one or more skin grafting procedures, and three patients required burn resuscitation. Four patients sustained minor ocular injuries. A subgroup of patients demands special review: 10 children younger than 10 years of age (mean age, 4.1 years) of which 70% were boys. Mean burn size was 15.5% TBSA; mean full-thickness burn size was 2.4% (four times larger than the mean burn size for the adult population).(ABSTRACT TRUNCATED AT 250 WORDS)     

The epidemiology, management, outcomes and areas for improvement of burn care in central Malawi: an observational study

This report describes the epidemiology of burn injuries and quantifies the appropriateness of use of available interventions at Kamuzu Central Hospital, Malawi, between July 2008 and June 2009 (370 burn patients). Burns accounted for 4.4% of all injuries and 25.9% of all burns presenting to the hospital were admitted. Most patients (67.6%) were < 15 years old and 56.2% were male. The most frequent cause was scalding (51.4%). Burns occurred most frequently in the cool, dry season and in the evening. The mean burn surface area (second/third degree) was 14.1% and most burns (74%) presented within 8 h. The commonest procedure was debridement and/or amputation. The mean hospital stay was 21.1 days, in-hospital mortality was 27% and wound infection rate was 31%. Available interventions (intravenous fluids, nutrition therapy, physiotherapy) were misapplied in 59% of cases. It is concluded that primary prevention should address paediatric and scald burns, and secondary prevention should train providers to use available interventions appropriately.     

Occupation-related burn injuries

Unlike household burn injuries, the characteristics of burn injuries in the workplace have not been well described. In an effort to understand the causes and effects of occupation-related burn injuries and to aid in prevention, we sought to describe work-related burn injuries by frequency, burn type, age of the patients, body parts burned, and occupation of the patients. This was a statewide, cross-sectional study of all burns that occurred in the workplace during 1994. Data on fatal injuries were obtained from the National Census of Fatal Occupational Injuries. Survey data from the North Carolina Department of Labor were used for nonfatal injuries. Burns caused 34 deaths (15.3%) and 1720 injuries in the workplace in 1994. Of the nonfatal injuries, 1363 (79.2%) were caused by exposure to caustic substances or hot objects or substances. The head and upper extremities were the most frequently injured body parts (936 injuries; 57.6%). The average age of those burned was 30.7 years; most of the patients ranged from 25 to 35 years old. High-risk occupations included vehicle and equipment cleaners, food service personnel, and millwrights (11.3%, 5.3%, and 5.2% of burn injuries, respectively). Unlike the flame burns that occur in homes, exposure to caustics and hot objects and substances caused the majority of on-the-job burn injuries. Protective gear for the head and upper extremities may prevent a significant number of burns. Education and prevention programs may best be directed at workers with high-risk occupations and workers in the 25- to 35-year age range.     

Perception of body image in children with burns, five years after burn injury.

Burn injuries and subsequent disfigurement may place children at high risk for psychologic dysfunction. If medical professionals are to aid the child in achieving psychologic resolution and acceptance of the injury, they must be aware of the stage of body-image perception that the child is experiencing. This study was designed to determine differences in body image between children with burns and children without burns through the use of human figure drawings. The experimental group consisted of 32 children with burns, aged 5 to 15 years, studied at approximately 5 years after burn injury. The control group consisted of 32 children without burns, aged 6 to 15 years. Subjects in the burn group were matched to control subjects by age and sex. There were no significant differences in body image in relation to any of the demographic measures except age. Age was inversely related to body image both in patients with burns and in control subjects.     

257例小儿烧伤特点分析

目的:了解小儿烧伤特征及发病规律,以寻求相应的预防措施。方法:对我院6年收治小儿烧伤住院病例257例,按年龄、致伤原因、发病季节、烧伤面积和部位及地域进行回顾分析。结果:小儿烧伤有一定规律性,婴幼儿期163例(63·4%),高于其他年龄期(P<0·01)。家庭是发病的主要场所,热液烫174例(67·7%)多于其他致伤原因(P<0·01)。发病季节在夏天及冬天多见,分别占32·68%、及33·46%。城乡分布有别,农村较城市多,农村小儿151例(58·74%)。面积以轻中度(烧伤面积小于30%)为主,占73·64%。烧伤深度以单纯浅Ⅱ°43例(16·73%),深Ⅱ°为主的175例(68·09%),有Ⅲ°烧伤的39例(15·17%)。烧伤部位无显著差异,一般是多部位。结论:小儿烧伤多数是可预防,加强安全防护意识,对降低小儿烧伤发生率有重要意义。     

Firefighter burn injuries: predictable patterns influenced by turnout gear

Approximately 100 firefighters suffer fatal injuries annually and tens of thousands receive nonfatal injuries. Many of these injuries require medical attention and restricted activity but may be preventable. This study was designed to elucidate etiology, circumstances, and patterns of firefighter burn injury so that further prevention strategies can be designed. In particular, modification of protective equipment, or turnout gear, is one potential strategy to prevent burn injury. An Institutional Review Board-approved retrospective review was conducted with records of firefighters treated for burn injury from 2005 to 2009. Data collected included age, gender, TBSA, burn depth, anatomic location, total hospital days per patient, etiology, and circumstances of injury. Circumstances of injury were stratified into the following categories: removal/dislodging of equipment, failure of equipment to protect, training errors, and when excessive external temperatures caused patient sweat to boil under the gear. Over the 4-year period, 20 firefighters were treated for burn injury. Mean age was 38.9 ± 8.9 years and 19 of 20 patients were male. Mean burn size was 1.1 ± 2.7% TBSA. Eighteen patients suffered second-degree burns, while two patients suffered first-degree burns. Mean length of hospitalization was 2.45 days. Scald burns were responsible for injury to 13 firefighters (65%). Flame burns caused injury to four patients (20%). Only three patients received contact burns (15%). The face was the site most commonly burned, representing 29% of injuries. The hand/wrist and ears were the next largest groups, with 23 and 16% of the injuries, respectively. Other areas burned included the neck (10%), arm (6.5%), leg (6.5%), knees (3%), shoulders (3%), and head (3%). Finally, the circumstance of injury was evaluated for each patient. Misuse and noncontiguous areas of protective equipment accounted for 14 of the 20 injuries (70%). These burns were caused when hot steam/liquid entered the gear via gaps in the sleeve or face mask. Three patients (15%) received injury due to removal/dislodging of their safety equipment, two patients (10%) suffered their injuries during training exercises when they were not wearing their safety equipment, and the final patient (5%) received burns due to sweat evaporation. Firefighter burn injuries occur to predictable anatomic sites with common injury patterns. Modification and optimization of gear to eliminate gaps that allow steam/hot liquid entry may decrease burn injury. Improving education regarding the use of protective equipment may also be beneficial.     

Healthcare resource utilization and epidemiology of pediatric burn-associated hospitalizations, United States, 2000.

The objective of this study was to describe the epidemiology and financial burden of burn-associated hospitalizations for children younger than 18 years in the United States. Retrospective data analysis of pediatric burn-associated hospitalizations was done using the Healthcare Cost and Utilization Project Kids' Inpatient Database for 2000. An estimated 10,000 children younger than 18 years were hospitalized for burn-associated injuries in the United States in 2000. These children spent an estimated 66,200 days in the hospital with associated hospital charges equal to USD 211,772,700. Total charges and length of stay for pediatric burn-associated hospitalizations in the United States during 2000 were associated with degree of burn, percentage of total body surface area burned, child's age, region of the United States, hospital location, and hospital type. Children 2 years old or younger were more likely to be nonwhite, be hospitalized for burns, and burn their hands/wrists, compared with children 3 to 17 years of age. Male children in both age groups were more likely to be hospitalized for burns than female children. Children 2 years old or younger were more likely to be burned by hot liquids/vapors and contact with hot substances/objects, while children 3 to 17 years were more likely to be burned by fire/flames. This study is the first national study on healthcare resource utilization for pediatric burn-associated hospitalizations to utilize the KID database. Burns are a major source of pediatric morbidity and are associated with significant national healthcare resource utilization annually. Future burn prevention efforts should emphasize implementing passive injury prevention strategies, especially for young children who are nonwhite and live in low-income communities.     

An analysis of 550 hospitalized pediatric burn patients in Hong Kong

A total of 550 acute burn patients under the age of 15 years were admitted to the Burns Unit of Prince of Wales Hospital, Hong Kong between March 1993 and February 1999. There were 337 males and 213 females with a male to female ratio of 1.58:1. The median age was 2.5 years and the median burn size was 5% total body surface area (TBSA). Toddlers of age < 2 years accounted for 235 (42.7%) of admission. Domestic burns resulted in 481 (87.5%) injuries followed by play-related burns that caused 34 (6.2%) admissions. Scalding was the most common cause of injury, which accounted for 497 (90.4%) admissions, followed by flame burns, which resulted in 45 (8.2%) injuries. Nine patients (1.6%) had inhalation injury requiring intubation and ventilatory support. The median hospital stay was 8 days and there was no seasonal variation in admission. The majority of patients (80.2%) had their wounds healed without any operation. Only 19 out of 550 patients (3.5%) had burns of 30% TBSA or larger, and only nine patients (1.9%) had inhalation injuries. Only one patient died in this series, which yielded a mortality rate of 0.2%.     

Hydrofluoric acid burns: a 15-year experience

Hydrofluoric acid (HF) is a strong inorganic acid commonly used in many domestic and industrial settings. It is one of the most common chemical burns encountered in a burn center and frequently engenders controversy in its management. We report our 15 year experience with management of HF burns. We reviewed our experience from 1990 to 2005 for patients admitted with HF burns. Primary treatment was with calcium gluconate gel. Arterial infusion of calcium and fingernail removal were reserved for unrelenting symptoms. There were 7944 acute burn admissions to our center during this study period, 204 of which were chemical burns. HF burns comprised 17% of these chemical burn admissions (35 patients). All were men, with a mean burn size of 2.1 +/- 1.5% (range, 1-6%) and hospital stay of 1.6 +/- 0.7 days (range, 0-3 days). The most common seasonal time of injury was in the summer. Twelve patients (34%) were admitted to the intensive care unit for a total of 14 intensive care unit days, primarily for arterial infusions. Ventilator support was not required in any patient. No electrolyte abnormalities occurred. All burns were either partial thickness or small full thickness with no operative intervention required and no deaths. The upper extremity was most commonly involved (29 patients, 83%). The most common cause was air conditioner cleaner (8 patients, 23%). HF is a common cause of chemical burns. Although hospital admission is usually required for vigorous treatment and pain control, burn size is usually small and does not cause electrolyte abnormalities, significant morbidity, or death.     

儿童烧伤发病趋势分析

目的通过分析23年来住院患儿烧伤发病特点，为儿童烧伤预防宣教和救治提供参考。方法分析1980--2002年住院患儿烧伤资料，从一般资料特点、烧伤原因以及相关因素和烧伤创面特点、院前急救和住院情况角度，研究小儿烧伤发病趋势。结果外来人口子女从1980--1989年的36．6％上升到1998--2002年的75．6％，且儿童烧伤年龄在降低。近5年热液灼伤占87．0％，由小儿父母导致小儿烧伤由20．7％上升到40．2％。居家发生小儿烧伤占90．0％左右，已经显著增高。头面颈部和躯干前侧是主要受伤部位。平均烧伤面积和3度烧伤面积随年代越近平均烧伤面积趋小。患儿手术数量减少但手术均次增加：院前当地医院先行处理的患儿低于10．0％，且随烧伤严重程度越重当地医院救治率越低。结论儿童的意外损伤中，烧伤的发病趋势不容忽视，应加强家长的预防宣教，加强院前急救的治疗措施，减少儿童意外伤害的发生与发展。     

Pediatric palm contact burns: a ten-year review.

Management and proper approach to pediatric palm burns remains unclear. Our burn center's approach includes early, aggressive range of motion therapy, combined with a period of watchful waiting, reserving grafting only for those palms that do not heal in a timely manner. We reviewed our experience using this approach over a 10-year period. We performed a retrospective review of all pediatric patients with palm burns admitted to our burn center from 1994 to 2004. A total of 168 patients (194 palms) were included in the study. The average patient was 1.3 years old. A total of 168 of the injured palms (87%) healed without need for surgery. The average time to healing was 13 days (range 5-34). The 19 patients (26 palms, 13.4%) who underwent excision and grafting were managed with thick split thickness skin grafts. Of these, four patients (five palms, 19.2%) underwent secondary reconstruction, at an average of 166 days after the initial surgery. Of the 168 (87%) palms managed without surgery, only three patients (four palms) required late reconstruction (2.4%). Reconstructive procedures consisted of full-thickness skin grafts (n = 7) and z-plasty (n = 2). We have found that the majority of patients in this study healed without need for acute or reconstructive surgery. We therefore recommend aggressive hand therapy and conservative surgical management of palm burns in children.     

Long-term follow-up of the impacts on obstetric complications of trunk burn injuries sustained during childhood

Limited data are available to assess the long-term effects of burns to the trunk sustained during early childhood on subsequent pregnancies. This population-based retrospective longitudinal study uses linked Western Australia hospital morbidity and midwives notification data for the period 1983-2008. During the study period, 824 girls younger than 15 years with non-erythema burns (partial thickness, full thickness, or unspecified burn depth) to the trunk were hospitalized in Western Australia. During the follow-up, 134 subjects with burns to the trunk during childhood were identified as having later pregnancies. The mean age at admission for burn injury was 5.7 ± 4.0 years, and the majority of burns were caused by scalds (51.5%) and flame (37.3%). For these subjects (N = 134), there were a total of 213 subsequent pregnancies. All pregnancies resulted in full-term live births. There were 142 (64.3%) vaginal deliveries, 26 (12.2%) breech or instrument, and 45 (21.2%) deliveries were by cesarean section. No admissions for scar conditions or revisions of burn scar or contracture were identified during any pregnancy (first to fourth) for subjects with burns to the trunk. Mode of delivery was not statistically significantly different from that experienced by subjects with burns sustained during childhood to other anatomical sites. For subjects in this study with less severe burns to the trunk, no specific detrimental impacts during pregnancy or delivery or to the fetus were identified. Further surveillance is required to gauge an accurate assessment of complications associated with severe trunk burns sustained during childhood.