Deep Partial Scald Burn in a Neonate: A Case Report of the First Documented Domestic Neonatal Burn:

Does the dressing matter in pediatric partial-thickness burns: a systematic review and meta-analysis

Superficial partial thickness burns typically receive nonoperative treatment, whereas deep partial thickness burns, which are prone to hypertrophic scarring, are usually managed through debridement followed by autologous split-thickness skin grafting. Various therapies have been developed to prevent wound infection and to enhance wound healing in pediatric partial-thickness burns. However, the choice of dressing by the surgeon can be influenced by various factors. It is worth noting that there is no standardized approach across all burn centers, leading to variations in care practices. To optimize pediatric patient care, a systematic review was conducted following PRISMA guidelines to review existing treatment options for partial thickness burns in children. Outcomes of interest were wound healing time, dressing changes, length of hospital stay, wound infections, need for grafting despite treatment, and hypertrophic scarring. A total of 68 studies with 8199 patients were included. The mean age of the included patients was 3.1 years, and the mean total body surface area of the burns was 15.6 %. Treatment groups included topical agents, bandages, skin analogues, or unclassified. Considering all treatment outcomes evaluated in this systematic review of the literature, non-silver dressings and skin analogues may have some benefit over topical agents in terms of wound healing time, length of hospital stay, hypertrophic scarring, pain management, and cost saving. Dressing changes, wound infections, and need for grafting did not significantly change between various treatments.

Safety of Silver Dressings in Infants; a Systematic Scoping Review

Silver-based dressings are used to reduce infection risk and optimize conditions for wound healing. They are widely used in the management of burns and other complex wounds. However, reports of elevated serum silver and concern over systemic toxicity have meant that their use in young children has been questioned. The aim of the current study was to map the literature relating to the use of silver-based dressings in children under 1 year of age. A systematic scoping review was conducted according to the methodology described by the Joanna Briggs Institute. Sources were identified from major medical databases as well as the gray literature. Inclusion criteria were the use of silver-based dressing in children under 1 year of age. Outcomes of interest were complications or adverse events attributed to silver-based dressings and elevated serum silver levels. A total of 599 sources were identified through the search strategy, with 110 included for review. Complications were described in 31 sources, with the most frequent being wound infection. No cases of argyria, kernicterus, or methemoglobinemia were reported. Six sources documented elevated serum silver levels in infants but none reported adverse events related to this. On the basis of current evidence, we suggest reserving silver dressings in infants under 1 for wounds that are at high risk of infection. Wound area and duration of treatment should be considered when assessing the risk of systemic absorption of silver. Standardized data collection and recording of complications and adverse events is recommended to better inform future clinical decision-making.

Life threatening deep scald burns in a neonate: A rare case report

Domestic burns in neonate are rare in literature. Neonates are high risk for burns because of their thin and fragile skin, fluid overload or dehydration as the fluid balance range is small and immature immune system leading to septicaemia. Neonates are not small adults, owing to their different physiological response makes the management of neonates challenging as the clinical signs are different from the adults and the resuscitation protocols or end points are also different. We present a case of 11 days old neonate, who sustained 51% scald burns when the hot water bag being used by her mother accidentally burst, the youngest reported case of domestic scald burns with such high percentage. The baby was managed by fluid resuscitation, antibiotics, dressings, ventilatory support for septicaemia and subsequently homograft application. The neonate was discharged with completely healed areas after 35 days of burns and is on regular follow up and no complications have been observed.