title: Evidence based management for paediatric burn: new approaches and improved scar outcomes.
abstract: Little evidence has been produced on the best practice for managing paediatric burns. We set out to develop a formal approach based on the finding that hypertrophic scarring is related to healing-time, with durations under 21 days associated with improved scar outcome. Incorporating new advances in burn care, we compared outcomes under the new approach to a cohort treated previously. Our study was a retrospective cross-sectional case note study, with demographic, treatment and outcome information collected. The management and outcome of each case was assessed and compared against another paediatric burns cohort from 2006. 181 burns presenting across a six month period were analysed (2010 cohort) and compared to 337 children from a previous cohort from 2006. Comparison of patients between cohorts showed an overall shift towards shorter healing-times in the 2010 cohort. A lower overall rate of hypertrophic scarring was seen in the 2010 cohort, and for corresponding healing-times after injury, hypertrophic scarring rates were halved in comparison to the 2006 cohort. We demonstrate that the use of a structured approach for paediatric burns has improved outcomes with regards to healing-time and hypertrophic scarring rate. This approach allows maximisation of healing potential and implements aggressive prophylactic measures.
authors.affiliation: Queen Victoria Hospital, Holtye Road, East Grinstead, West Sussex RH19 3DZ, UK; Brighton and Sussex Medical School, University of Sussex, Brighton, East Sussex BN1 9PX, UK. Electronic address: l.kishikova1@uni.bsms.ac.uk.
authors.forename: Lyudmila
authors.initials: L
authors.lastname: Kishikova
authors.affiliation: Brighton and Sussex Medical School, University of Sussex, Brighton, East Sussex BN1 9PX, UK.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Smith
authors.affiliation: Queen Victoria Hospital, Holtye Road, East Grinstead, West Sussex RH19 3DZ, UK.
authors.forename: Tania C S
authors.initials: TC
authors.lastname: Cubison
mesh_terms: D000293:Adolescent; D001458:Bandages; D001830:Body Surface Area; D002056:Burns / Q000150:complications / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D017439:Cicatrix, Hypertrophic / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D002985:Clinical Protocols; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003646:Debridement; D019468:Disease Management; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008405:Massage; D012189:Retrospective Studies; D016038:Skin Transplantation; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Burns; Paediatric; Scalds