Burn Injuries in Children
Angela Drelles, RN, BSN
Pediatric hand burns are the most common type of burn injury treated at Children's Hospital Colorado Burn Center. This is because toddlers are innately curious and newly mobile. They explore their surroundings through touching and feeling with their hands.
When a child sustains a burn injury to the palm and /or fingers of the hand, it is important to recognize the potential adverse impact on normal motor development, including fine motor skill maturity and gross motor skill acquisition. Often a hand that is functionally impaired as a result of thermal injury is one that was not properly managed from the start of the healing process.1
The American Burn Association recommends referral for all but the most minor pediatric hand burns. Treatment at Children's Hospital Colorado Burn Center is multidisciplinary and begins with dressing changes one to two times a week using a topical antibacterial ointment and soft-casting technique to allow the palm(s) and finger(s) to heal in the position of extension. It is critical during this period of time to promote circulation, prevent maceration and minimize the risks of burn wound infection. Because all open wounds heal by contracture, a pediatric occupational therapist should be involved so that range of motion is preserved and contracture formation is prevented. Once the burn wounds have healed, the therapist will continue to work with the parent(s) and child to make sure that any range of motion that was lost during the healing process is regained.
Primary care physicians should consider the following criteria when referring a child with a burn injury of the hand:
- Age of the patient
- Mechanism of burn injury (heat contact, scald or flame)
- Depth of burn injury
- Current range of motion
- Edema and/or infection present
- Current developmental skills
- Crossing of joint spaces and/or palmar crease involvement
- Long-term plan of care
The morbidity associated with pediatric hand burns can be minimized with optimal management and utilization of a multidisciplinary team approach. When managed in a coordinated long-term program the child with a hand burn can be expected to have excellent functional results.
To refer a patient to Children's Hospital Colorado Burn Center, call (720) 777-6604 to schedule an appointment or call One Call, (720) 777-3999. If insurance requires a referral, all paperwork should be faxed to (720) 777-7170.