Children at high risk of burn injuries

2015-04-30 14:39

SOUTH Africa has an extremely high incidence of burn injuries, with an estimated 3,2% of the population suffering from a thermal injury annually.

These accidents most commonly occur in densely populated, informal settlements where paraffin is the most used source of fuel, and cooking often takes place on fires and primus stoves on the floor.

These informal dwellings often consist of just one room, making it incredibly difficult to plan safe kitchen and sleeping areas.

Children are particularly vulnerable to burn accidents, and it is one of the leading causes of death and injury to young children in South Africa.

The Red Cross War Memorial Children’s Hospital in Cape Town is the only paediatric hospital in Sub-Sahara Africa with a trauma unit and a burns unit dedicated exclusively to children under 12 years old. The Specialist C2 Burns Unit treats more than 3 500 children with serious burns every year. Some 85% of the patients are younger than six and 98% are from disadvantaged communities.

The main causes of burn injuries seen at the Red Cross Burns Unit are hot water from tipping containers above the child’s head or at ground level, and from unattended fires.

When the skin is exposed to excessive heat, electricity or corrosive chemicals, the resulting tissue damage is known as a burn.

Burns are usually categorised according to the severity of the tissue damage:

) First-degree burns, which affect only the top layer of skin (epidermis), causing mild pain and redness;

) Second-degree burns, which extend to the layer below the epidermis, the dermis, and cause pain, redness, and blisters that may ooze;

) Third-degree burns, which involve all layers of the skin and can also damage the underlying bones, muscles and tendons. The burn site appears pale, charred or leathery, and where nerve endings have been destroyed there is no sensation in the area.

The appropriate treatment for burns depends on the extent of the tissue damage, the cause of the burn, and whether or not an infection is present. Infection is a primary concern, followed closely by dehydration.

A burn injury leads to a loss of fluid through the skin and potential symptoms include thirst, weakness, lightheadedness and dizziness.

While the burn injuries themselves cause tremendous pain, the healing process is equally traumatic. As the new skin begins to form, intolerable pruritus (post-burn itch) develops. This condition, caused by severe dehydration, can be unbearable for anyone, but particularly young children.

The itchiness causes them to scratch incessantly, which, in addition to the obvious discomfort, has the detrimental effect of destroying the newly-formed skin. This leads to additional skin grafts, sepsis and scarring, as well as longer hospitalisation.

Psychological problems due to post-burn itching are also common and can vary from an inability to sleep, fear, anxiety, depression and anger.


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