A retrospective survey of 169 burns cases admitted to Port Moresby General Hospital was conducted for the period 1978 to 1984. A third of the patients were young children. Hot-water burns were the commonest type of injury, accounting for 43%. This was followed by accidental falls into a fire and suicidal kerosene burns, which accounted for 28% and 13% respectively. Post-burn contractures were the commonest long-term complications. Prevention of burns is theoretically very attractive but hard to achieve in rural and squatter populations who rely almost entirely on open fires for cooking and heating. Burns awareness campaigns by all government and community groups stressing the dangers of open fires and leaving children unattended would no doubt take a long time but might ultimately produce tangible results.
Burns - epidemiology ; Burns - therapy ; Hospitals, General - statistics & ; numerical data ; Patient Admission - statistics & ; numerical data

OBJECTIVETo analyze the epidemiological characteristics of pediatric burn in the midwest region of Inner Mongolia and the related areas, and to provide reference for seeking pertinent measures of prevention and treatment.

METHODSMedical records of patients hospitalized in the 253rd Hospital of PLA, the 322nd Hospital of PLA, and the Inner Mongolia Autonomous Region Hospital from January 1996 to December 2010 were collected. Patients were divided into pediatric burn group with specific reason (group SF, with scald resulted from construction defect of Guo-lian-kang--a heatable brick bed linked to a cooking pot), and burn control group with other causes (group C) according to the main injury cause. Clinical data of patients in both groups, including general condition, family background, occurrence regularity, and outcome, were analyzed. The epidemiological trend of variation before and after taking preventive measures (1996 to 2001 and 2002 to 2010) was compared. Data were processed with chi-square test and rank sum test.

RESULTS(1) General condition: out of 16 595 pediatric burn patients, 15 816 cases (95.3%) suffered scald due to liquids with high temperature, and 779 cases (4.7%) suffered burns due to other causes. Patients in group SF (scald due to specific cause--Guo-lian-kang) accounted for 32.2% (5089/15 816) of the total suffered scald by liquids with high temperature, and 30.7% (5089/16 595) of all the inpatients the cause of burn was related to Guo-lian-kang (group SF). The patients in group SF admitted to the 322nd Hospital of PLA accounted for 34.2% of all the inpatients admitted to this hospital (1803/5267), more than the other two hospitals in this study. The number of patients in group C was 11 506, accounted for 69.3% of all the inpatients. The age of patients ranged from 8 months to 5 years in group SF and 1 month to 12 years in group C. The age of the majority of patients ranged from 1 to 3 years in both groups. The ratio of male to female was 2.1:1.0 in group SF and 1.4:1.0 in group C. The incidence of scald involving multiple body parts in group SF (3590 cases accounting for 70.5%) was obviously higher than that of group C (6311 cases accounting for 54.8%, χ(2) = 361.138, P < 0.01). In both group SF and group C, the incidence in different sites was ranked from high to low as follows: upper limbs, lower limbs, the head-face-neck region, and the trunk. The degree of injury in group SF was much more severe than that of group C (Z = 27.770, P < 0.01). The rate of patients without pre-hospital treatment was 31.2% (1588/5089) in group SF, which was obviously higher than that of group C (24.8%, 2857/11 506, χ(2) = 73.010, P < 0.01). The rate of patients treated with cryotherapy was obviously lower in group SF (14.7%, 747/5089) than in group C (19.6%, 2255/11 506, χ(2) = 57.636, P < 0.01). The rate of patients treated with delayed resuscitation (6 hours after injury) in group SF (31.5%, 1601/5089) was obviously higher than that of group C (7.8%, 897/11 506, χ(2) = 1545.234, P < 0.01). (2) Family background and occurrence regularity: in group SF, 67.3% (3424/5089) of the patients came from farming area, 22.1% (1123/5089) from villages and towns, and 10.7% (542/5089) from urban areas. In group C, 32.4% (3727/11 506) of the patients came from farming area, 48.4% (5570/11 506) from villages and towns, and 19.2% (2209/11 506) from urban areas. Most of the patients in group SF (77.8%, 3958/5089) were injured between October and March, while most of the patients in group C (58.2%, 6697/11 506) were injured between May and October. (3) Outcome and epidemiological variation: the cure rate of patients in group SF was 32.3% (1645/5089), which was obviously lower than that of group C (44.7%, 5143/11 506, χ(2) = 215.615, P < 0.01). The mortality of patients in group SF was 1.6% (79/5089), and it was obviously higher than that of group C (0.4%, 46/11 506, χ(2) = 62.700, P < 0.01). From 1996 to 2001, patients in group SF accounted for 42.5% (2213/5212), while patients in group C accounted for 57.5% (2999/5212) of the inpatients scalded by hot liquid. After taking preventive measures against injury due to Guo-lian-kang, incidence of scald injury in group SF was lowered to 27.1% (2876/10 604), while the incidence in group C remained at 72.9% (7728/10 604) of the inpatients with hot liquid scald from 2002 to 2010. The difference between the two periods was statistically significant (χ(2) = 376.695,P < 0.01).

CONCLUSIONSThe defect of construction of Guo-lian-kang is one of the main factors that lead to a high incidence of pediatric burn in the midwest of Inner Mongolia. Installation of a protective bannister between the cooking pot and the "kang (heatable brick bed)" can obviously reduce the incidence of scald injury. Special injury-causing factors, unprofessional pre-hospital treatment of the wound, delayed resuscitation after shock are the main causes of increasing mortality and disability, and they constitute the key targets of prevention and treatment of such injury in future.

Burns ; epidemiology ; Child ; Child, Preschool ; China ; Female ; Humans ; Infant ; Male

Sepsis and septic shock as a result of an invasive infection are challenging problems in extensively burned patients, and frequently end in multiple organ dysfunction syndrome (MODS). It is of great significance to further elucidate the pathogenetic mechanisms, and to seek novel intervention strategies to prevent and treat sepsis/MODS secondary to severe burns. A more complete understanding of the pathogenetic mechanisms of postburn sepsis would certainly elicit a number of potential therapeutic strategies for it. It is our belief that comprehensive clinical measures for management of severe sepsis should include rapid, adequate fluid resuscitation for burn shock, early feeding, effective control of infection, early escharectomy, and reinforcement of organ support. Once burn wound sepsis occurs, prompt removal of infected necrotic tissue is the key procedure to ensure a successful result. Further study is necessary to determine the precise mechanisms of these protective effects and the clinical advantages for postburn sepsis using evidence-based methodology system.
Burns ; complications ; Humans ; Sepsis ; epidemiology ; etiology ; prevention & control

Burns ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Hospitalization ; Humans ; Male ; Seasons

OBJECTIVE: To understand the epidemiological characteristics of workers who are burn patients, and to provide basis for prevention and treatment of burn at work. METHODS: We investigated 4 078 burn workers in 9 cities in Hunan provincial enterprises, and different trades managed by municipal government from January 1st, 2005 to December 31st, 2010. RESULTS: The incidence rate of employment injury was 94.84 per 10 thousand workers each year in Hunan. That of the enterprises directly managed by Hunan Medical Insurance Bureau was 93.71 per 10 thousand workers each year, and that of the enterprises managed by Medical Insurance Bureaus of cities or districts was 95.02 per 10 thousand workers each year. The burn incidence accounted for 2.00% of the total work injury in Hunan Province (7.35% in the enterprises directly managed by Hunan Medical Insurance Bureau and 1.39% in districts and industries). There were 4 078 burn patients from the sorted units [1 823 out-patients and 2 255 in-patients; 3 498 males (85.78%) and 580 females (14.22%) with age of (38.64±11.56) years]. The ratio between males and females was 6.03:1. Among the 4 078 patients, 2 979 were from the rural area (71.78%), with 1 100 out-patients and 1 379 in-patients. The burn was mostly mild and moderate (64.66%), and mainly occurred on the face, head, arms, and legs (61.55%). The main causes of burn were heating power (74.1%), chemical stuff (14.37%), and electric power (10.78%). The death rate was 1.42%. The burn accidents often happened between July and September. The average time from being burned to be in the hospital for treatment was 3.91 hours. CONCLUSION Burn accidents, especially mild and moderate burn, occur mainly in young, married and poorly educated males from rural areas. Heating power, chemical stuff, and electric power are the key causes for burn. Work injury prevention measures should be improved in high risk enterprises.
Adult ; Burns ; epidemiology ; China ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Occupational Injuries ; epidemiology

OBJECTIVETo analyze the epidemiological characteristics of hospitalized children with burn injuries in Fujian Medical University Union Hospital, so as to provide evidence to complete an adequate, timely, and effective prevention and treatment system of children with burn injuries.

METHODSMedical records of children with burn injuries, aged 14 and under, hospitalized in the Department of Burns from July 2012 to June 2015 were collected. Data of gender and age, location and cause of injury, time of injury, state of injury, admission time after injury, first aid, length of hospital stay, and treatment and so on were recorded. They were divided into 4 age brackets: less than or equal to 1 year old, more than 1 year old and less than or equal to 3 years old, more than 3 years old and less than or equal to 7 years old, more than 7 years old and less than or equal to 14 years old, then gender and cause of injury of children in the 4 age brackets were analyzed. Admission months of the children were divided into spring (March to May), summer (June to August), autumn (September to November) and winter (December to February of the following year), and then the cause of injury of children in each season was analyzed. Severities of male and female children, length of hospital stay of children with different causes of injury were analyzed. Data were processed with chi-square test, Wilcoxon rank-sum test.

RESULTSOut of 2 608 inpatients with burn injuries, 1 407 children with burn injuries, aged 14 and under, accounting for 53.9%, were admitted in the recent 3 years. The ratio of male to female was 1.6 ∶1.0. Children more than 1 year old and less than or equal to 3 years old ranked the largest number (68.3%, 961/1 407) in the 4 age brackets. There was statistically significant difference in constituent ratios of gender of children among the 4 age brackets (χ(2)=11.00, P=0.012). One thousand three hundred and seventy-two children were burned indoors (97.5%), while 35 children were burned outdoors (2.5%). Scalding with hot fluids was the most common cause of burn (95.0%, 1 337/1 407). There was statistically significant difference in constituent ratios of injury cause of children among the 4 age brackets (χ(2)=107.23, P<0.01). There was statistically significant difference in constituent ratios of injury cause of children more than 7 years old and less than or equal to 14 years old compared with those of the other 3 age brackets (with χ(2) values from 12.88 to 119.85, P values below 0.01). Most burn accidents occurred between 17: 00-20: 59 (33.5%, 472/1 407). Burns were more likely to happen in April to October. July (10.4%, 146/1 407) and August (10.5%, 148/1 407) were the crest-time. Most of the children were burned in summer (35.3%, 496/1 407). There was statistically significant difference in the injury cause of children among each season (χ(2)=14.61, P=0.024). The burn degrees of male and female children were mainly mild or moderate, and there was no statistically significant difference in the severity (Z=-0.39, P>0.05). The trunk was the most involved anatomic site (61.1%, 859/1 407). Most of children were admitted to hospital within 2 hours post burn (79.7%, 1 121/1 407). Majority of children were taken off clothes as first aid on spot or did not receive any treatment. Most of the children were discharged within 2 weeks after admission (80.0%, 1 126/1 407). There was statistically significant difference in length of hospital stay of children with causes of hot liquid scald, flame burn, electric burn, high temperature solid burn, chemical burn (χ(2) =17.33, P=0.002). Most of the children were treated with non-surgical methods, and the majority of the children got better condition or totally recovered and then discharged.

CONCLUSIONSThe majority of hospitalized children with burn injuries in our unit are young boys in preschool period, who were burnt by hot fluid at the time of dinner and bathing at home during summer. So we should make more effort on popularization of prevention about burn.

Adolescent ; Burns ; classification ; epidemiology ; Burns, Chemical ; Burns, Electric ; Child ; Child, Hospitalized ; statistics & numerical data ; Child, Preschool ; Female ; Hospitalization ; Humans ; Infant ; Inpatients ; Length of Stay ; Male

OBJECTIVETo investigate the epidemiological factors in the first aid, early management, and treatment of chemical burns.

METHODSMedical records of 615 inpatients with chemical burns out of 2682 burn patients hospitalized from January 2001 to December 2010 were screened to retrospectively analyze the clinical data, including gender, age, burn area and depth, occurrence regularity, injury cause, injury-causing chemicals, wound site, complications, pre-hospital management, treatment and prognosis. Annual number of burn patients and annual number of patients with chemical burns were statistically analyzed with linear trend test.

RESULTS(1) Among all the chemical burn patients, 562 (91.4%) were male and 53 (8.6%) female. The mean age of patients was (32 ± 12) years. Burn area ranged from 1% to 95%, with mean area of (30 ± 25)% TBSA. Full-thickness burn area ranged from 0 to 85%, with mean area of (18 ± 24)% TBSA. (2) The annual number of burn patients showed a slow trend of increase during the last decade (χ(2) = 4.009, P < 0.05). There was no statistically significant difference in the annual number of patients with chemical burns among the last decade (χ(2) = 0.060, P > 0.05). Chemical burns mainly occurred in summer and autumn, and the incidence gradually increased in April, peaked in August, and then gradually decreased. (3) Five hundred and seventy-two cases (93.0%) were injured while working, among these patients 70.8% (405/572) were injured in private enterprises. (4) Acid was the most common injury-causing chemical (299 patients, accounting for 48.6%). (5) The extremities and head were the most involved areas. (6) Among 615 patients with chemical burns, 47 cases (7.6%) were complicated by inhalation injury, 94 cases (15.3%) by ocular burns, 51 cases (8.3%) by combined injury, and 67 cases (10.9%) by poisoning. (7) Most patients did not receive (30.4%, 187/615) or only insufficient (61.1%, 376/615) immediate irrigation after injury in pre-hospital management. (8) Two hundred and twelve patients (34.5%) underwent skin grafting or flap transplantation after early total or tangential excision of eschar within one week post injury. Among all the patients, 599 cases were cured with 11 eyes becoming blind in 8 patients, and sixteen patients died with a mortality rate of 2.6%.

CONCLUSIONSPatients with chemical burns accounted for a high proportion of the burn patients admitted to our unit in the same period, and they were mainly injured while working. Sufficient irrigation and immediate detoxification are key points in the treatment of chemical burns. Early total or tangential excision of eschar of deep wounds could reduce the possibility of poisoning.

Adolescent ; Adult ; Aged ; Burns, Chemical ; epidemiology ; therapy ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the H(2)S pollution in cabins which caused the fishermen's eye burns.

METHODSFifty-six fishing boats' H(2)S concentration was surveyed and 56 fishermen's eyes were inspected. The air samples were collected from 21 fishing boats' cabins, where the eye burns took place and the monitoring conditions met the inspection requirement, in order to confirm the concentration of H(2)S when eye burns and the systemic poisoning happened. Thirty fishing boats were divided into two groups: one was using air ventilating and spraying, the other was using naturally ventilation to find out the effective method of dispersing H(2)S. Five fishing boats were surveyed in which the fishermen had slight symptom of bulbar conjunctiva hyperemia and cough to find out the minimum concentration of H(2)S which caused the eye burns and respiratory mucosa.

RESULTSAmong 56 fishermen who were surveyed, 46 fishermen's eyes (92 eyes) burnt and they were from 21 vessels, 10 of them (20 eyes) were moderate, 36 of them (72 eyes) were light. The concentration of H(2)S in the 21 fishing boats' cabins which caused eye burns was (99 ± 38) mg/m(3). The first measuring of the concentration of H(2)S in the 30 fishing boats in which fish were not discharged yet was (219 ± 31) mg/m(3). Air ventilating and spraying group's concentration of H(2)S was (213 ± 24) mg/m(3), while that of naturally ventilation group's was (225 ± 36) mg/m(3). Dispersing after 1 hour, the concentration of H(2)S of air ventilating and spraying group was (21 ± 3) mg/m(3), the decreased concentration was (192 ± 21) mg/m(3), fell 90%; the concentration of naturally ventilation group was (184 ± 36) mg/m(3), the decreased concentration was (41 ± 8) mg/m(3), fell 18%. The difference between the two groups' decreased concentration was significant (t = 25.627, P < 0.05). The threshold value of H(2)S concentration that could cause the eye burns was 38 mg/m(3)(exposure time 120 min). In 7 vessels, the concentration of H(2)S in the cabins was (123 ± 9) mg/m(3) where 10 fishermen's moderate eye burns happened. In other 7 vessels, the concentration of H(2)S in the cabins was (54 ± 7) mg/m(3) where 19 fishermen's light eye burns happened. The difference of H(2)S concentration between the two groups was significant (t = 14.236, P < 0.05).

CONCLUSIONHigh H(2)S concentration and long exposure time in cabin can cause serious eye burns. The bilge air ventilation and inner cabin spraying are the effective method to clear the H(2)S in cabin within short time.

Air Pollutants, Occupational ; analysis ; Confined Spaces ; Eye Burns ; epidemiology ; etiology ; Fisheries ; Humans ; Hydrogen Sulfide ; analysis ; Ships

PURPOSE: Instant noodle is one of the most popular noodle and its consumption is increasing annually. So scalding burns caused by Instant noodle are comparatively common. Instant noodle can lead to contact burn caused by noodle as well as scalding burn by soup. Because the depth of the burn can be deeper than general scalding burn, it can cause physical or psychological disability and the medical and social expense is not a few. The purpose of this study was to investigate the epidemiology and clinical features of the scalding burn caused by Instant noodle. METHODS: Retrospective research was conducted 165 patients with scalding burn by Instant noodle among patients admitted to our burn medical center from May 2011 to April 2016. Subjects were classified by age, gender, affected site and degree and treatment method. RESULTS: For 6 years, 165 subjects went through hospital treatment because of the scalding burn by Instant noodle. It consisted of 48 infants, 74 children and adolescence, and 43 adults. The average TBSA (total body surface area, %) was 3.43. The number of patients exceeding 10% were 3. The most common affected site was thigh in 35.5% and there was no big differences between each age group. 8 patients did operations and 6 did dermabrasion. CONCLUSION: From May 2011 to April 2016, about 7% of total scalding burn patients was injured by Instant noodle. Considering the characteristics of scalding burn by Instant noodle, conservative treatment was preferred to surgical treatment. 149 of total 165 patients were done conservative treatment using cultured allogenic keratinocytes.
Adolescent ; Adult ; Body Surface Area ; Burns* ; Child ; Dermabrasion ; Epidemiology ; Humans ; Infant ; Keratinocytes ; Methods ; Retrospective Studies ; Thigh

PURPOSE: Pediatric burn still generates social problem leading to physical and mental sequelae for ages. We studied to help make a program for the prevention of pediatric burn. METHODS: We analyzed retrospectically 2759 acute burn patients under the age of 15 years in recent 5years (January 2000 - December 2004). RESULTS: 1553 males and 1226 females were investigated, with a male to female ratio of 1.25:1. The greatest number of burn patients were those with an age of 1-2 years(1435, 52%). Scalding burn was the most common cause of injury, which accounted for 1980 (71.8%) patients, followed by contact burns(286, 10.4%), flame burn(229, 8.3%), steam burn(141, 5.1%). Especially steam burn was the second cause of injury in the age under 1 year, while flame burn was the same in the age over 3 years. During recent 5 years, incidence of contact burn increased over twofold despite the others did not changed substantially. Variation of seasonal incidence is minimal and most of the patients(2545 cases, 92.2%) had burns of < = or 20% TBSA. The median hospital stay was 18.3 days, and the rate of operation was 35.4% with an high rate in electrical burn(70.6%), steam burn(68.8%), contact burn(65%). 27 patients died in this series, which yielded a mortality rate of 1%. CONCLUSION: We expect that these data will be used as a basis for prevention of pediatric burn.
Burns* ; Epidemiology ; Female ; Humans ; Incidence ; Length of Stay ; Male ; Mortality ; Seasons ; Social Problems ; Steam