Les brûlures de la face chez l'enfant. À propos de 197 patients

doi:10.1016/S0294-1260(01)00020-6

Annales de Chirurgie Plastique Esthétique

Volume 46, Issue 3, 2001, Pages 190-195

https://doi.org/10.1016/S0294-1260(01)00020-6 Get rights and content

Résumé

La brûlure de la face est un accident fréquent chez l'enfant. 197 dossiers d'enfants hospitalisés ont été étudiés de 1991 à 1996. Cent seize patients avaient moins de trois ans. Un quart était issu de milieux défavorisés, avec neuf cas de maltraitance. Les liquides bouillants étaient la cause de la brûlure 113 fois. La surface brûlée totale était inférieure à 10 % dans 63 % des cas, la surface faciale dans 4 % avec surtout une atteinte jugale, mentonnière et frontale. Le tronc et les membres supérieurs étaient souvent atteints. Cent trente patients ont été hospitalisés, quatre sont décédés. La durée moyenne de séjour était de 17,31 jours. Cinquante deux enfants ont eu des greffes de peau mince. La cicatrisation a nécessité 21 jours chez les enfants non greffés et 35,65 jours chez les greffés. Vingt huit enfants ont été admis au centre de rééducation. Les cicatrices étaient pâles, souples et discrètes chez 158 enfants à deux ans. Onze enfants ont eu des traitements secondaires. Les auteurs analysent les résultats et insistent sur la prévention.

Abstract

Facial burns frequently occur in child. A total of 197 burned patients with facial localisation were seen during the time period (1991–1996) covered by this retrospective study. One hundred and sixteen patients were less than three years old. A quater of the child were issued from poor social classes with nine cases of child abuse by burning. One hundred and thirteen injuries were performed by hot water or drinks. The total burn area was less than 10% in 63% of the cases. The average facial burned area was 4%. The cheek, the front and the chin were often concerned. Low limbs and trunck were unjuried in all cases. 130 patients needed hospitalisation, and stayed in average 17.31 days at hospital. Four patients died from respiratory complications, all after flame injuries. Fifty two child needed skin split grafts. Complete cicatrisation was observed after 21 days of treatment in child without grafts, and after 35.65 days in child whith skin grafts. Twenty eight patients needed physiotherapy in center. The scars had a correct cosmetic apperarance, without retraction and inflammatory signs in 158 child after two years. Eleven patients needed other surgical treatment. The authors analyse the results and insist on prevention.

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Cited by (6)

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2019, Safety Issues in Beverage Production: Volume 18: The Science of Beverages
Burns are the injuries that occur as a result of the action of thermal, chemical, or electrical agents. They are called one of the most devastating type of trauma.
Approximately 1% of all children sustain a burn injury each year. Several publications have appeared documenting that children under 5 years old are at the highest risk of burns, especially scalds—burns caused by hot liquids.
Burns have impact on mortality of children and the quality of survivors’ life. Due to limited therapeutic options, prevention is crucial.
We can distinguish four levels of prevention of burns in children: primordial, primary, secondary, and tertiary. The most important aim is to establish and maintain conditions that minimize hazards to health and introducing new methods to reduce the incidence of the disease.
Several practical questions arise when dealing with aspect of prevention of burns in children and beverages. This paper is a modest contribution to the ongoing discussions. Particular attention is paid to the strategies with proven or promising evidence of effectiveness described in available literature.
The analysis of the studies and trends in burn epidemiology worldwide indicates that it is possible to effectively reduce the number of burns in children.
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Retrospective studies on the types and causes of facial burns are important because the patterns might vary in different societies. Our aim was to assess the burn-related factors of significance that might be useful in healthcare planning and implementing preventive strategies, adding to the body of current data on the subject.
A retrospective cross-sectional study was conducted to assess the data from a major burns referral center during a 5-year period (2009 to 2013). The data relevant to age, gender, cause, source, location, burn degree, extent (body surface area [BSA]) of the burns, and mortality were gathered from comprehensive patient medical records, recorded, and analyzed using SPSS, version 20, software (SPSS, Chicago, IL).
Within the study period, we found 808 documented cases of second- and third-degree facial burns. These burns were more common in men (81.9%) and in the 16- to 35-year age group (42.3%). The mean hospitalization was 9.85 ± 8.94 days. In 443 patients (54.83%), 10 to 19% of their BSA was burned, and 3.06% had associated inhalation burns. The most common burn was scalding (19%), and the deadliest was burns from acid, with a mortality rate of 7.4%. Accidents accounted for 776 burns (96.03%). Other causes were attempted homicide (16 cases, 1.98%) and suicide attempts (16 cases, 1.98%). The overall mortality was 1.6%.
The key findings were that second- and third-degree facial burns were more common in males aged 16 to 35 years with burns covering 10 to 19% of the BSA. Accidental scalding was commonly responsible for the second-degree burns, and electrical accidents were commonly responsible for third-degree facial burns. Burn accidents occurred more often at the patient's home.
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2013, Burns
Citation Excerpt :
A possible explanation for these differences in prevalence is the difference in population, setting, registration and definition of facial burns. Surprisingly, only few publications specifically focus on the epidemiology of facial burns, such as one in French children in a regional hospital [12], one in a Nigerian burn unit [13] or one in an United States paediatric burn centre [5]. Other studies that report on facial burns tend to focus on specific mechanisms of injury (e.g. flambé drinks [14] or air bag infusion [15]).
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Facial burn incidences per 100,000 were 15.1 for ED visits, 1.3 for hospital admissions and 1.4 for burn centre admissions. A total of 2691 patients were admitted to Dutch burn centres; 47.5% (n = 1277) had facial burns of which 20.5% received primary facial surgery and 5.3% received facial reconstruction in follow-up. Predictors of facial burns and facial surgery were identified. Predictors of facial reconstructive surgery were burns to the neck (ventral), fire/flame burns and number of facial surgeries in the acute phase of the burn.
One in five patients with facial burns admitted to a Dutch burn centre received primary facial surgery and 1 in 20 received facial reconstructive surgery within a follow-up of minimum 2 years.
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Burns are devastating injuries scarring patients, both physically and psychologically, for life. This remains particularly true for facial burns. Eyelid burns occur in about 10% of thermal injuries and is a considerable challenge for the reconstructive surgeon given the particular anatomy of the eyelids. Reconstruction of the eyelids following burn injuries has been performed by plastic surgeons since the earliest days of reconstructive surgery, yet a consensus on a treatment regime has not been reached and plastic surgeons are divided on the subject. Controversies exist regarding the excision and debridement of eschar, temporary suture and surgical tarsorrhaphy, timing of surgery for eyelid contraction, and the role of full and split-thickness skin grafts in eyelid reconstruction. This paper describes the particularities of the treatment of burned eyelids in our Burn Center.
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2023, Soft Tissue Injuries of the Head and Neck
Home delivery of an injury prevention kit for children in four French cities: A controlled randomized trial
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Article originalLes brûlures de la face chez l'enfant. À propos de 197 patientsFacial burns in child. A review of 197 patients

Résumé

Abstract

Burns

Arch Pediatr

Surg Clin North Am

Burns

Burns

Les brûlures des paupières. Bilan rétrospectif de 11 ans

Ann Chir Plast Esthét

L'épidémiologie de la brûlure de l'enfant de 0 à 15 ans

Product related children accidents. A survey of 1590 cases

Scand J Soc Med

Article original
Les brûlures de la face chez l'enfant. À propos de 197 patientsFacial burns in child. A review of 197 patients