Inflicted burns and scalds in children.

Ten children who had been burnt and six who had been scalded by parents or those caring for them were seen over three years. In no case did the thermal injury affect more than 5% of the body surface and there were no deaths. In seven the perineum or buttocks were in the burnt area. In 12 children there was evidence of other inflicted injury including six recent fractures. Staff caring for burnt children should be aware of this type of inflicted injury. X-ray skeletal surveys should be carried out in doubtful cases and a case conference initiated with the appropriate social work services to consider supervising the family after the child's discharge or taking legal care proceedings.     

Management of airway complications of burns in children

Children who have been exposed to smoke in a confined space or who have soot or burns, however minimal, on the face should be admitted to hospital. Respiratory distress may be delayed, but if it is progressive the patient should be curarised, intubated, and mechanically ventilated. Unless ventilation continues for 48 hours, followed by 24 hours' spontaneous respiration against a positive airway pressure, stridor and pulmonary oedema may recur. An endotracheal tube small enough to allow a leak between it and the oedematous mucosa must be passed to prevent laryngeal damage and subsequent subglottic stenosis. High humidity of inspired gases keeps secretions fluid and the endotracheal tube patent. A high oxygen concentration compensates for deficient oxygen uptake and transport caused by pulmonary lesions and the presence of poisonous compounds interfering with oxygen transport. Dexamethasone to minimise cerebral oedema and antibiotics to reduce the incidence of chest infections should be given.     

爱康肤银离子敷料用于小儿重度烧伤的临床应用

目的：探讨爱康肤银离子敷料治疗小儿重度烧伤的临床疗效以及用药安全性。方法将本院收治的重度烧伤患儿30例随机分成两组,对照组15例采用传统敷料处理,观察组15例采用爱康肤银离子敷料处理,分别记录两组患儿高热反复次数、持续时间、惊厥发生的次数,心率快慢、每小时尿量的多少和创面加深程度。结果①5~12岁的儿童,发育逐渐成熟,除了高热、心率、尿量方面和创面加深程度外,还增加了疼痛程度的分级。②与传统换药方式比较爱康敷银离子敷料作用下,其患儿高热、惊厥的次数减少,心率明显下降,疼痛程度降低。③爱康敷银离子作用下,创面开始上皮化及完全上皮化的时间缩短,儿童心率下降。结论爱康肤银离子敷料可减少或减轻发热次数和程度,减轻疼痛刺激,减少换药次数,从而减轻病情,缩短创面愈合时间,临床建议推广运用。     

重度烧伤高热患儿碘伏消毒液湿敷的降温效果观察

目的：探讨碘伏消毒液创面湿敷对重度烧伤患儿高热期间降温及伤口愈合的效果。方法：以单纯随机抽样,选择97例重度烧伤体温在38.5℃以上的患儿分为碘伏消毒创面湿敷组、物理降温组、药物降温组,采用3种降温方式进行降温并观察伤口愈合情况。结果：碘伏消毒创面湿敷组与物理降温组疗效比较,P〈0.01。碘伏消毒创面湿敷组与药物组疗效比较,P〈0.01。伤口愈合时间缩短。结论：碘伏消毒创面湿敷组对重度烧伤患儿降温效果,伤口愈合均优于其他组,值得临床推广应用。     

Childhood burns

A five year retrospective survey of children admitted to Dunedin Hospital for the treatment of burn injuries was undertaken. Fifty-nine percent of the victims were male, 76% were under five years of age, and the most common type of injury was a scald. A significant number of the victims received friction burns from washing machine wringers. This finding contrasts with other burn surveys and a number of possible explanations are advanced. More in depth investigations of specific incidents are required to assist and assess the efficacy of current preventive efforts.