Management of Paediatric Burns

Almost one-third of all burn centre admissions involve children under the age of ten years. Caring for the burned child continues to demand the close attention of a multidisciplinary team to the patient's many needs. Paediatric burns impose enormous economic burdens on families and on society as a whole. Scald burns secondary to household accidents predominate in most series, constituting 70% of all thermal injuries in infants, toddlers, and pre-school children. Most of these injuries are potentially preventable. Children with 5% TBSA third-degree burns or more than 10% TBSA second-and third-degree burns need to be hospitalized for proper resuscitation and burn wound management. Children with burn injuries involving the face, hands, or genital areas also require hospitalization. The goal of the resuscitation of hospitalized burn victims is to restore circulating blood volume and to minimize the early stress response. This is accomplished with adequate fluid replacement, correction of hypoxia and ventilatory disturbances, prevention of hypothermia, and adequate control of pain and anxiety. Minor burns can be treated at home with topical ointments. The recently introduced MEBO (Moist Exposed Burn Ointment) seems to be highly promising in this regard. Burn wounds should be encouraged to heal in the shortest possible period by a judicious combination of topical therapy, eschar excision, and skin grafting.