The safety of general anaesthesia in paediatric patients undergoing the application of Biobrane® for small scalds.
BACKGROUND
Each year more than 5000 children present to English and Welsh hospitals for the management of scalds; 60% of these are small scalds of less than 10% body surface area. There are no agreed UK care pathways for this injury. One method of management is to use a biosynthetic wound dressing after thorough wound cleaning. In children, this usually utilises general anaesthesia. This study investigates the incidence of adverse events during anaesthesia for the application of biosynthetic dressings in children with small-area scalds.


METHODS
The medical records of 500 consecutive admissions to a tertiary care paediatric burn centre between July 1st 2007 and June 30th 2012 were analysed. The primary outcome was any patient-related adverse event incurred as a result of the general anaesthesia. Secondary outcomes included delays in discharge and any recovery sequelae to the adverse events.


RESULTS
There were 21 (4.2%) documented adverse events associated with 500 episodes of anaesthesia. Of these, the majority (52%) were documented as self-resolving laryngospasm. All episodes were temporary with no recovery sequelae and did not delay discharge from the post-anaesthetic recovery area.


CONCLUSIONS
The use of general anaesthesia in this setting for the application of biosynthetic dressings in children with small-area scalds has a low incidence of anaesthesia-related complications with no associated long-term sequelae. This incidence is similar to that quoted for adverse events related to anaesthesia for other procedures and is lower than that reported for procedures using sedation.
South West Regional Burns and Plastic Surgery Service, Department of Anaesthesia, Frenchay Hospital, Frenchay, Bristol BS16 1LE, UK. Electronic address: sarahwarwicker@hotmail.com.
Sarah J
SJ
Warwicker
South West Regional Burns and Plastic Surgery Service, Department of Anaesthesia, Frenchay Hospital, Frenchay, Bristol BS16 1LE, UK. Electronic address: clintonlobo@me.com.
Clinton A
CA
Lobo
University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, UK. Electronic address: Narges.Dailami@uwe.ac.uk.
Narges
N
Dailami
South West Regional Burns and Plastic Surgery Service, Department of Anaesthesia, Frenchay Hospital, Frenchay, Bristol BS16 1LE, UK. Electronic address: amber.young1@nhs.net.
Amber E
AE
Young
D039602:After-Hours Care / Q000706:statistics & numerical data; D000367:Age Factors; D000707:Anaphylaxis / Q000209:etiology; D000768:Anesthesia, General / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000209:etiology; D001986:Bronchial Spasm / Q000209:etiology; D002053:Burn Units; D002056:Burns / Q000601:surgery*; D002406:Catheterization, Peripheral / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D003253:Consultants; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000209:etiology; D007003:Hypoglycemia / Q000209:etiology; D007022:Hypotension / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000009:adverse effects; D007826:Laryngismus / Q000209:etiology*; D007902:Length of Stay; D008297:Male; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data; D053120:Respiratory Aspiration / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D015599:Trauma Severity Indices
C042816:Biobrane; D020099:Coated Materials, Biocompatible
Adverse events; Biosynthetic dressings; Burns; General anaesthesia; Paediatric; Scald management