SUMMARY.A survey was made of 22 burned children treated in the Hospital Maria Pia (Oporto, Portugal) between February and August 1999. The criteria for admission were burns in up to 15% body surface area, absence of traumatic lesions, and age under 13 yr. Age, origin, accident details, burn agent, kind of lesion and body area, length of hospital stay, and surgical interventions were considered.
The Hospital Maria Pia is a hospital for sick children in Oporto, Portugal. Burned children were for a long time treated at this institution by the Paediatric Surgery and Plastic Surgery Services.
Since February 1999 an agreement has been operative with the Burns Intensive Care Unit of the Hospital da Prelada for the transfer of seriously burned children. This has been followed by better conditions for burned children admitted to Hospital Maria Pia.
Emergency Service admission is the paediatric surgeon’s work and the Plastic Surgery Service carries out the subsequent care. The criteria for admission are as follows: burns in up to 15% body surface area (BSA), absence of traumatic lesions, and age under 13 yr. Hospitalization in the Service is limited to two beds.
A protocol for treatment and a data base have been created.
Between February and August 1999, twenty-two children were registered under this protocol. The patients were treated as out-patients and/or in-patients. Children with minor burns were excluded.
The admission rate of the twenty-two children (13 boys and 9 girls) was 3.1 per month. The ages ranged between 13 months and 12 yr (mean, 3.7 yr).
Three patients came directly from home, while 19 were transferred from other hospitals in the region in a 120 km radius from Oporto. Transfer was carried out by a parent in 21 cases and by a nurse in only one.
Information about the accident and the treatment given before admission was adequate in 19 cases and insufficient in the remaining three.
The average delay between the accident and admission to our hospital was 3 h in acute cases (between 15 min and 14 h). Patients transferred after a period of hospital stay arrived between days 2 and 8 (average, 4 days).
The place of the accident was the home in 21 cases and school in one case.
Thirteen children lived in rural areas and nine in urban areas.
The burn agent was boiling water in 15 cases, contact with a hot surface in three, boiling oil in two, and low-tension electric current in the remaining two.
The circumstances of the accidents presented some similarities: six children pulled a pan standing on a cooking stove, three were burned by bath water, three were burned by a boiling liquid spilt accidentally by a parent, two pulled on a tablecloth and spilt liquid over themselves, three came into contact with a hot surface such as an iron or a stove, two suffered electric shock, and one child burned his foot on hot coals.
The average total BSA was 4.1% (range, 1 to 12%).
Fourteen children were hospitalized. The average stay was 9 days, ranging from 2 to 30 days. In an effort to reduce hospital stay, whenever possible the child left hospital and returned to continue treatment.
Three children had other pathologies (diabetes, nephropathy, and congenital immunodeficiency).
Ten patients were operated on: five were skin-grafted in one operation, four were subjected to two separate surgical procedures (wound cleaning and skin graft), and one child was operated on four times.
Paediatric hospitals have a suitable environment for the care of burned children who do not meet the criteria for Burn Care Units, because they have the proper human relations and medical resources.
At the Hospital Maria Pia, the Plastic Surgery and Paediatric Surgery Services have the necessary technical means for acute burn care, with easy access to the co-operation of other specialities such as paediatrics, paedopsychiatry, and physiotherapy. We also have a Burns Consultation Service for the resolution of after effects.
RESUME. Une étude a été conduite sur 22 enfants brûlés hospitalisés dans l’Hôpital Maria Pia (Oporto, Portugal) entre février et août 1999. Les critères pour l’admission étaient les brûlures jusqu’à 15% de la surface corporelle, l’absence de lésions traumatiques, et l’âge inférieur à 13 ans. Les Auteurs ont considéré l’âge, la cause, les circonstances de l’accident, le type de lésion et l’extension des lésions, la durée de l’hospitalisation et les interventions chirurgicales.