Epidemiological and Clinical Profile of Pediatric Burns in the COVID-19 Era: The Experience of a Reference Center

Abstract

Pediatric burns represent a significant public health problem. We analyzed the characteristics of pediatric burns in a reference center, in order to identify better strategies for prevention and care. Burn patients admitted to the pediatric departments of our hospital from January 2020 to June 2022 were retrospectively evaluated. Age, gender, the etiology of injuries, the total burn surface area (TBSA), the degree of burns, the length of hospital stay (LOS), concomitant SARS-CoV-2 infection, and burn surface microbial colonization were analyzed. Forty-seven patients were included in the analysis (M:F = 1:0.67). Most of the cases involved patients between 0 and 4 years of age (83%). Hot liquid burns accounted for 79% of cases, flame burns for 9%, thermal burns for 6%, scald burns for 4% and chemical burns for 2%. Mean TBSA was 14 ± 11%. A second-degree lesion was detected in 79% of patients and third-degree in 21%. Mean LOS was 17 days. No additional infection risks or major sequelae were reported in patients with SARS-CoV-2 infection. Fifteen different species of bacteria plus C. parapsilosis were isolated, while no anaerobic microorganisms were detected. In the light of our experience, we recommend a carefully planned and proactive management strategy, always multidisciplinary, to ensure the best care for the burned child.

Pediatric First-Degree Burn Management With Honey and 1% Silver Sulfadiazine (Ag-SD): Comparison and Contrast

“…There were no statistically significant differences observed among pediatric burn cases regarding sex. Our results were similar to an earlier study conducted in the USA and Italy [158,159]. Nevertheless, one study at Linköping University Hospital of Sweden reported that more males (70%) were burned cases than females [160].…”

Pediatric Plastic Surgery in the COVID-19 Era

“…This hospital had zero transmissions between COVID-19-positive patients and others, and treatment of the COVID-19 infection was not burdened by major sequelae. 67 During the stay-at-home order, they reported delayed presentation of greater than 24 hours in 19% of patients after injury, which they speculate to be attributed to initial fear of viral exposure at the hospital during the pandemic. 67 An Israeli dedicated pediatric tertiary care center reported a rise in pediatric burn cases and admissions, especially from domestic accidents, and time from injury to presentation in the emergency department was longer compared with pre-COVID.…”

“…67 During the stay-at-home order, they reported delayed presentation of greater than 24 hours in 19% of patients after injury, which they speculate to be attributed to initial fear of viral exposure at the hospital during the pandemic. 67 An Israeli dedicated pediatric tertiary care center reported a rise in pediatric burn cases and admissions, especially from domestic accidents, and time from injury to presentation in the emergency department was longer compared with pre-COVID. As a result of the increased admissions, they established a prehospital clinic to triage patients as those admitted to the hospital or those treated with telehealth.…”

“…67 Most of the injuries, 36%, were of the head and neck, followed by the extremities at 21%. 67 This contrasted the commonly documented locations of burn wounds before COVID-19, the extremities. This hospital had zero transmissions between COVID-19-positive patients and others, and treatment of the COVID-19 infection was not burdened by major sequelae.…”

“…In an article from an Italian hospital, designated as a "COVID-19 pediatric hub," the characteristics of the pediatric burn patients during the COVID-19 pandemic were described. 67 The median age was 2.1 years. The most common cause was hot liquid burns, affecting 79% of patients, mostly of hot water; however, there were vastly different etiologies based on the age group.…”