トラウマと治療のジャーナル

Management of Severe Burns in Children at the Intensive Care Unit of the Borgou Regional University Teaching Hospital (CHUD-B) in Benin

Abstract

Alexandre S Allode, Blaise Adelin Tchaou, Alphonse Noudamadjo, Childéric Affiémin Avossevou, Elie Tamou and Gervais M Hounnou

Background: Severe burns in children are common and their mortality is very high, particularly in developing countries. Objective: This study aims to investigate the epidemiological, clinical and therapeutic aspects of severe burns admitted to the CHUD-B intensive care unit. Patients and methods: It was a case-control study with descriptive and analytical purpose carried out in the CHUD-B from January 1st, 2010 to December 31, 2014. The study involved patients under 15 years of age with severe burns admitted to the intensive care unit. Findings: Among the 65 patients hospitalized for severe burn, 49 were children i.e. 75.3%. The mean age of burned children was 3.5 years (2 months and 12 years as extremes). Children under 5 years of age represented 71.4%. Males were predominant (57.1%). Average waiting time for admission after accident was 2 hours. Burn was accidental and most burns occurred at home (93.9%). The causative agent was thermal (100%); scalding represented 67.3%, and then flames 32.7%. Average body surface area burned (BSAB) was 30% and 2nd degree burns represented 95.9%. At the scene of the accident 46.5% of patients had received care. Treatment consisted of occlusive dressing with Biafine® and vascular filling. The administration of analgesic and antibiotics was systematic. No surgical treatment was provided. The average length of stay in the intensive care unit was 7 days. Complications were noted in 73.5% of the patients. Anemia (75.0%), hypovolemic shock (33.3%) and local infection (22.2%) were the main complications. Mortality rate was 40.8%. This high mortality was correlated to three major complications with P value less than 0.05. These complications were: hypovolemic shock, pneumonia and septicemia. Conclusion: Severe burn is life-threatening for the child. Primary prevention is the best way to combat against that condition.