Burns : journal of the International Society for Burn Injuries
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A prospective study was conducted on paediatric thermal injury patients admitted to the Burns Unit at King Fahd Hospital, Jeddah, Saudi Arabia over a 2-year period (December 1985 to December 1987). A total of 197 patients (out of 319) were paediatric, aged up to 18 years. Infants and toddlers accounted for 59.4 per cent and adolescents for 14.2 per cent. Scalding and flame injuries accounted for 98 per cent with most injuries occurring at home (97.5 per cent) and the overall paediatric mortality rate was 4.4 per cent.
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Five children who suffered burns clinically regarded as full skin thickness loss were grafted with cultured allogeneic skin from newborn prepuce. The wounds had remained open and infected without healing for about 20 days before the patients were received in the burn unit. To avoid losing surviving deep epidermal cells the wounds were débrided but not deeply excised and, a few days before allografting, they were washed with isodine solution and sterile water, and treated with silvadene cream application. ⋯ On the other hand, since allografting is an adequate therapy to provide early temporary coverage in extensively burned patients, we developed conditions for banking cultured skin to make it available for immediate use. The conditions described allow banking of the cultured grafts for 15-20 days with retention of clonal growth ability similar to that of unstored epithelia. The results show that cultured epidermal cells obtained from human newborn foreskin, when used as allografts for coverage of full skin or deep partial skin thickness burns, allow rapid epithelization of the burn wounds.
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The author has analysed 339 patients with extensive burns admitted to a teaching hospital and found them to be most common in poor socioeconomic groups with low incomes, poor housing and illiteracy. Thermal injuries afflicted 89 per cent of the patients and were generally accidental and occurred in homes with floor-level cooking: chemical and electrical burns (the remaining 11 per cent) were uncommon. Kerosene pressure stove accidents were a common cause of thermal burns and occurred in 65 per cent of the patients. ⋯ Mishandling of kerosene pressure stoves was the commonest cause and occurred in 65.7 per cent of the patients and the next most common cause was wearing loose garments. Kerosene pressure stove accidents occurred commonly in the age group 16-35 years and were rare in other age groups. These burns were relatively more extensive, deep and carried a high mortality.