D. S. Feuer1, B. Fenner2, O. Sharaf1, R. Hawkins2, S. D. Larson3 1University Of Florida,College Of Medicine,Gainesville, FL, USA 2University Of Florida,Department Of Surgery,Gainesville, FL, USA 3University Of Florida,Division Of Pediatric Surgery,Gainesville, FL, USA
Introduction:
Pediatric burn-related injuries are a common cause of hospitalization and are a major contributor to morbidity and mortality. Larger total body surface-area (TBSA) burns are associated with prolonged immunosuppression and increased risk of secondary infection. However, there is little data regarding the consequences of smaller area burns. We hypothesize that smaller burn wounds (<15% TBSA) carry significant risk of immunosuppression and secondary infection in children.
Methods:
Using the DiCorp V6 Burn Database, we performed retrospective analysis of all pediatric patients admitted to our institution from July 2016–February 2020 with second or third degree burn < 15% TBSA. Baseline data collected included demographic data, burn type, and grafting requirements. Outcome measures include any infection other than burn site, within 30 days of injury.
Results:
There were 494 pediatric patients that met inclusion criteria. Seventeen (3.4%) presented to our institution with a non-burn site infection < 30 days. Two (0.4%) patients required hospital admission (herpes simplex virus and a retropharyngeal abscess). The most common infection was upper respiratory infections (URIs)–present in 11 of 17 children (64.7%). Two (18.2%) patients with a URI, developed advanced complications of their URI (scarlet fever, and retropharyngeal abscess). Other infections included urinary tract infection, conjunctivitis, molluscum contagiosum, impetigo, and diffuse abscesses. The median age for infected children was 1 year old, compared to 3 years old for all studied patients.
Conclusion:
Secondary infection following a minor burn is a potential contributor to morbidity among children. While this study is limited by its retrospective nature, the data suggest that children may be in an immunocompromised state after relatively small burns. Scarlet fever and retropharyngeal abscesses are both rare complications of URIs. It is likely that the rate of infection in this population is significantly higher compared to our results, as many patients likely presented to a primary pediatrician outside of our hospital network. Future prospective work is needed to confirm the higher rate of secondary infection in pediatric burn patients and to identify the factors most predictive of this complication.