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Pediatric emergency care · May 2024
Improved Short-Term Prognosis of Pediatric Partial-Thickness Burns: Emergency Conservative Debridement Under Topical Anesthesia.
- Hailiang Liu, Dongjie Li, Huageng Yuan, Tianjun Sun, PengCheng Li, Zhiwei Cai, and Chuan'an Shen.
- From the Department of Burns and Plastic Surgery, the Fourth Medical Center, Chinese PLA General Hospital, Beijing, China.
- Pediatr Emerg Care. 2024 May 1; 40 (5): 390394390-394.
ObjectivesEarly wound management for pediatric patients with partial-thickness burns in the emergency department remains debatable. This study aims to evaluate the value of emergency conservative debridement under topical anesthesia in improving short-term prognosis of pediatric partial-thickness burns.MethodsThis retrospective cohort study enrolled children with partial-thickness thermal burns presenting to the emergency department within 6 hours postburn. All the enrolled patients were divided into 2 groups: the debridement group and the dressing group. The associations between emergency conservative debridement and time to reepithelialization was analyzed by using Kaplan-Meier curves with log rank test and multivariate Cox regression analysis. Moreover, the associations between emergency conservative debridement and in-hospital cost and length of stay were also evaluated.ResultsAll baseline characteristics between groups were comparable (all P > 0.05). Emergency conservative debridement under topical anesthesia significantly decreased the median value of time to reepithelialization (13 vs 14 days, P = 0.02). Cox regression analysis showed that emergency conservative debridement significantly improved wound reepithelialization after adjusting for burn size (odds ratio, 4.07; 95% confidence interval, 1.64-10.11; P < 0.01). The mean length of stay of patients receiving conservative wound debridement was lower than that of patients in the wound dressing group (14.3 ± 7.3 vs 18.8 ± 10.4 days, P < 0.01), but not in terms of mean in-hospital cost per 1% total body surface area (2.8 ± 1.9 vs 3.0 ± 2.1 × 103 RMB per 1% total body surface area, P = 0.58).ConclusionsEmergency conservative debridement of pediatric partial-thickness burns under topical anesthesia significantly improves the wound healing outcomes without increasing health care burden.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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