M. Bachier1, S. E. Hammond2, T. Jones3, R. Williams1, T. Jancelewicz1, A. Feliz1 1University Of Tennessee, Health Science Center,Division Of Pediatric Surgery,Memphis, TN, USA 2University Of Tennessee, Health Science Center,Department Of General Surgery,Memphis, TN, USA 3University Of Tennessee, Health Science Center,Departments Of Pediatrics And Preventive Medicine,Memphis, TN, USA
Introduction:
Pediatric accidental scald injuries result in frequent Emergency Room visits and hospitalizations. We investigated whether burns due to food preparations produce more significant injuries leading to more extensive care and greater morbidity.
Methods:
We performed a six-year(2007-2012) retrospective chart review at a self-standing children’s hospital. All children less than 18 years old admitted for accidental scald burns(E Codes 924, 924.2; ICD-9 codes 940–949) were selected. Demographics, injury pattern, treatment and outcome data were analyzed to compare cooking versus non-cooking scald burns. The Mann-Whitney U test, a Chi-square test, and the negative binomial were used to compare continuous, categorical, and count data between groups. A Bonferroni correction was used for multiple testing. A p < 0.05 was considered to be statistically significant.
Results:
We reviewed 308 records of children with scald burns, 85% cooking related and 15% non-cooking related (mostly bathing injuries). For all groups the majority of patients were male, African American, had public insurance, and median age was two years. Cooking burns were preferentially distributed over the head, neck and upper body, while non-cooking burns were distributed over the lower body(p values <0.02). Despite differences in burn distribution, median total body surface area for second and third degree burns was equal for all study groups(p values >0.11). Extent of care, measured by need for consults or feeding tubes (data not shown), readmissions, number of surgical debridements, or number of clinic visits, was not significantly different between groups(Table 1). Length of stay was significantly longer for non-cooking burns when compared to all cooking-related burns(Table 1). On subgroup analyses, patients burned with semisolid substances had the shortest length of stay(p <0.02); however, these patients suffered more wound contractures and limited mobility due to scarring. Likewise, patients burned with grease had a higher rate of wound contractures and limited mobility(Table 1).
Conclusion:
The majority of accidental scald burns in our population were related to food preparation and occurred in young children. Cooking-related scald burns with semisolid and grease produce more significant morbidity than non-cooking scald burns, demonstrated by more complications and greater long term disability. These patients may benefit from more aggressive therapies to prevent long term complications. Burn prevention strategies should target safety and education during food preparation.
