Paediatric ambulant burn care treatment in a tertiary burn unit

Abstract

Background: Burn injuries are a global public health crisis and a significant cause of morbidity and mortality in low-to middle-income countries (LMICs). Sub-Saharan Africa carries an extraordinary burden of burn injuries amongst children under 18 years of age. The purpose of this study was to assess burn wound outcomes, and parental health-seeking behaviour of children managed as outpatient burns.

Methods: A retrospective audit was performed of children presenting with burns to the emergency centre at Red Cross War Memorial Children’s Hospital during two seasonal periods. Standard demographics, wound management and outcome were reviewed. Adherence to provincial burn referral was also assessed. Descriptive statistics were performed on information gathered using a standardised questionnaire.

Results: One thousand one hundred and ninety-one (1 191) children with burns were attended to in the study period, 57 (5%) were excluded due to incomplete records. There was a relative increase in the number of patients (158, 32%) in winter/spring compared to summer/autumn. Two hundred and eighty-nine (24%) patients did not warrant admission, and this subgroup cohort was the study’s focus of enquiry. Most of these, 157 (54%), were male, and the average age was 32.5 (R 2–153) months. The average TBSA was 2.5% (R 1–8%) and scalds predominated, 252 (87%). Many patients (148, 51%) defaulted follow-up appointments due to transport difficulties and financial constraints.

Conclusion: This study demonstrated similar demographics, burn injury patterns and seasonal variability compared to international literature. Referral criteria were strictly adhered to by referral facilities. Fiscal constraints determine the ability to attend follow-up appointments. Telemedicine programmes have been instituted as a solution.