Long-term functional sequelae after paediatric burns.

Abstract

Ninety-one patients with at least 5 per cent (median 10 per cent, maximum 50 per cent) total body surface area (TBSA) burns were clinically re-examined on average 17.3 yr after primary injury. The patients had sustained mostly superficial dermal scalds. The most common long-term functional sequelae were impaired tanning (n = 67; 77.7 per cent), diminished tactile sensibility (n = 50; 56.2 per cent) and increased reddening (n = 14; 15.6 per cent) either in the sun or the Finnish sauna. Five patients (6.3 per cent) had limited joint mobility and one patient experienced constrictive scars on her trunk during pregnancy. Scar appearance was significantly associated with impaired tactile sense (chi 2 = 11.87, DF = 2, p < 0.01; Spearman's R = 0.27, p = 0.03). Surprisingly, better scar appearance showed more disturbed touch sensation. The primary operative treatment (early excision and split skin grafting) was not associated with diminished sense of touch (chi 2 = 1.24, DF = 1, p = 0.27). Neither were scar appearance and poor tanning significantly associated (chi 2 = 1.63, DF = 1, p = 0.4). Only three patients suffered no functional detriments. In this series the harmful functional consequences were generally slight. The aetiological background (scalds) and the relatively small, superficially burned skin area probably explains the good late outcome. However, since nearly every burn-injured child will have some signs of the injury in adulthood, children present a constant challenge in the effort for better burn care and prevention.