Abstract
Introduction
Since toddlers explore with their hands, contact burns continue to be a major pediatric problem. The purpose of this report is to review a pediatric burn unit’s 8-year experience with contact burns of the hand.
Methods
After IRB approval, a review of pediatric contact hand burns that occurred between 2006–2014 was performed. We examined the causes and outcomes in pediatric contact hand burns in a single pediatric burn program.
Results
In the 8-year span, 535 children suffered contact burns to the hand (67 per year). The majority suffered hands burns from an oven or stove (120). The other etiologies included burns from a fireplace (76), clothing iron (65), curling or straightening iron (50), and firepit or campfire (46). The mean age at time of injury was 2.62 years old, with a range of 2 months old to18 years old. Male children (339) typically burned their hands more than females (197). Locations of injury included the palmar surface, dorsal surface, fingers tips/thumb, wrist or a combination of several different areas. Most children burned the palmar aspect of their hand (384) compared to the dorsal aspect (61). These burns typically cover small total body surface areas (mean 1.08% TBSA), with only 2% of burns comprising >5% TBSA. Approximately, 84% of these patients did not need surgery, but 86 (16%) had skin grafting (usually full-thickness) and 26% needed a secondary surgery. Of those that needed more than two, the average number of procedures was 3.6. Approximately 4.1% of patients needed a tertiary surgery. Causes for tertiary surgeries included contractures and graft loss. Out of twenty-two patients that needed a third surgery, 59% were due to graft loss and 41% were due to contractures.
Conclusions
Contact burns to the hand continue to be a major problem for toddlers. Children are most likely to burn themselves on an oven or stove, fireplace, clothing iron or curling/straightening iron. The palmar surface of the hand is the most likely site. While most children do not require surgery, approximately 16% require grafting. A significant number of those patients need reconstructive surgery. Clearly, current prevention efforts have failed to reduce these injuries.
Applicability of Research to Practice
Palm burns are common in young children. Efforts should focus on preventing these injuries.