[Treatment of scald injuries in infants and toddlers: the Zurich concept].
The majority of patients requiring hospital treatment for burns are infants and toddlers. Most cases are scald injuries involving less than 15 % of the body surface area. The risk of hypothermia during transport and acute treatment of patients in this age group is very high and therefore appropriate measures should be taken to minimize this risk. The frequency of child abuse at this age is higher than in older children and hence a detailed investigation of accident details should rule out this eventuality. Innovations in the field of wound treatment such as the use of allogenic or autogenic keratinozytes promise to be very effective especially in this age group. In order to avoid the development of scars with cosmetic and functional deficits, it is important to judge the correct point of time to perform a split-thickness skin graft during the further treatment. In this age group, the donor site for the split-thickness skin graft should be the scalp if possible and furthermore the grafts should not be expanded. These two simple measures can improve the cosmetic and functional outcome in infants and toddlers substantially.
Schiestl
C
C
Zentrum für brandverletzte Kinder, Chirurgische Klinik, Universitätskinderspital, Zürich, Switzerland. clemens.schiestl@kispi.unizh.ch
D000698:Analgesia; D001458:Bandages; D002053:Burn Units; D002056:Burns / Q000601:surgery*; D002649:Child Abuse / Q000175:diagnosis; D002675:Child, Preschool; D003646:Debridement; D004632:Emergency Medical Services; D004954:Esthetics; D005260:Female; D006801:Humans; D007223:Infant; D015603:Keratinocytes / Q000637:transplantation; D008297:Male; D019221:Mandatory Reporting; D016038:Skin Transplantation; D013557:Switzerland; D014945:Wound Healing / Q000502:physiology