Assaults with a sharp object in small children: a 16-year review

Abstract

Injuries as a result of assaults with sharp object in small children are rare and data on them are scarce. The Red Cross War Memorial Children's Hospital is presently the only Children's Hospital in South Africa with a dedicated Level 1 trauma unit for children under the age of 13 years, and we have an annual trauma load of over 10,000 patients. A retrospective review was performed using the Data Base of the Child Accident Prevention Foundation of Southern Africa at the Red Cross War Memorial Children's Hospital in Cape Town. All children who were coded as an 'assault with sharp object' were included in this study. Five-hundred-and-fifty-one (551) patients were retrospectively reviewed, of which 373 (68%) were boys and 177 (32%) girls. The mean age of the children was 7 years. The majority of children (51%) sustained injuries at the head or neck region, 26% sustained an injury at the trunk and 26% at the extremities. The majority of children sustained minor injuries (62%), thirtythree (33%) moderate and 5% severe injuries. Three children died. The most commonly recorded object used in the assault was glass or (broken) bottles (33%) and knives (18%). Other objects recorded included sticks, stones, pens, pencils, scissors, machetes and nails. The majority of perpetrators were known to the child. Assaults with a sharp object in small children are relatively rare and represent only 0.328% of all paediatric trauma patients. Although rare, these injuries carry a significant morbidity and even mortality. The majority of injuries occurred at home. Prevention programmes, specifically targeting the caretakers, should be implemented to prevent these tragic injuries.

The incidence, spectrum and outcome of paediatric trauma managed by the Pietermaritzburg Metropolitan Trauma Service

“…This high incidence of intentional trauma and penetrating trauma has been reported from other major centres in South Africa, and reflects persistently high levels of interpersonal violence in the country two decades after the advent of democracy. [13][14][15] The operative workload for paediatric trauma in the PMTS is significant. With the increased use of non-operative techniques to manage blunt trauma, the operative load for trauma in the developed world has decreased significantly.…”

Traumatismo Craniano Penetrante Incomum em uma Criança

“…Os ferimentos penetrantes do crânio se constituem em lesões traumáticas bastante severas e de prognóstico desfavorável frequente. Lesões por projéteis e estilhaços são as causas mais comuns deste tipo de traumatismo, porém outros objetos envolvidos são facas, pregos, estacas e tesouras 8,10 .…”

“…As complicações comuns incluem infecções, na forma de abscesso cerebral ou meningite, déficits neurológicos focais e convulsões. Outras complicações são representadas por ressangramento, diabetes insipidus e outras disfunções neuroendócrinas, fístula liquórica e hidrocefalia 6,10 .…”

“…Sugere-se o uso de anticonvulsivantes por 7 dias para prevenção de convulsões pós traumáticas precoces, no entanto não é comprovada a prevenção tardia das convulsões 10 .…”