Pediatrik el yanýklarýnýn klinik sonuçlarý ve baþlýca neden olarak çocuk ihmalinin deðerlendirilmesi: Geriye dönük bir çalýþma

AMAÇ: Çocuk yanýklarýnýn çoðu yakýnýnda bir yetiþkin varken meydana gelmektedir. Bu durum yanýk nedeni olarak yetiþkin dikkatsizliði veya ihmalinin rolünü düþündürmektedir. Bu çalýþmanýn amacý pediatrik el yanýklarý hakkýnda klinik veriler saðlamak ve çocuklarda yanýk yaralanmalarýnda ihmalin rolüne dikkat çekmektir.
GEREÇ VE YÖNTEM: Çalýþmaya Eylül 2017–Ekim 2018 tarihleri arasýnda üçüncü basamak yanýk merkezinde yatarak tedavi edilen çocuklar dahil edildi. Yaþ, cinsiyet, yanýk etiyolojisi, olay yeri, yakýnlardaki eriþkin varlýðý, fiziksel istismar veya ihmal varlýðý, yanýk toplam vücut yüzey alaný, yatýþ süresi ve komplikasyonlar kaydedildi.
BULGULAR: Yanýk merkezinde yatarak tedavi edilen 335 pediatrik yanýk hastasý arasýndan el yanýðý olan 89 hasta çalýþmaya alýndý. Hastalarýn %79.8’i 6 yaþ altýndaydý. Yanýk kazalarýnýn %88.8’i iç mekanlarda meydana gelmiþti. El yanýklarýnýn çoðu haþlanma yanýðý idi. Hastalarýn %71.9’unda yanýk yaralanmasý esnasýnda yakýnlarda bir yetiþkin vardý. El yanýðý olan hastalarýn 19’u (%21.35) ihmal olarak deðerlendirildi. Tüm ihmal olgularý altý yaþýn altýndaydý.
TARTIÞMA: Pediatrik yanýklar çoðunlukla ev içerisinde ve yakýnlarda bir yetiþkin varken meydana gelmiþtir. Sýcak içecek tüketme alýþkanlýklarý, mutfakta tehlikeli piþirme uygulamalarý ve farkýndalýk eksikliði yanýk kazasýna yol açan bazý önemli konulardýr. Etiyolojik bir neden olarak ihmal el yanýklarýnýn %21.35’inde tespit edilmiþtir. Tekrarlanan yanýk yaralanmalarýnýn önlenmesi için genel önlemlerin yaný sýra hastalarýn deðerlendirilmesinde ihmal bulgularýna özellikle dikkat edilmesi gerekmektedir. Ebeveynin yetersiz denetim veya ihmali düþünüldüðünde resmi makamlara bildirimde bulunulmalýdýr.

Clinical outcome of pediatric hand burns and evaluation of neglect as a leading cause: A retrospective study

BACKGROUND: Majority of the pediatric burns happen when an adult is nearby the child. This suggests the role of adult carelessness or neglect as a cause of burns. The aim of this study is to provide clinical data on pediatric hand burns and to draw attention to the role of neglect in pediatric burn injuries.
METHODS: Children admitted to a tertiary burn center between September 2017 and October 2018 were included in the study. Epidemiological data including age, sex, etiology and place of injury, presence of caregiver nearby, physical signs of neglect or abuse, clinical outcomes including burned total body surface area, length of admittance, and complications were recorded.
RESULTS: A total of 335 pediatric burns were admitted to the burn center. Among them 89 patients with hand involvement were included in the study. Most of the patients were under the age of 6 (79.8%) and 88.8% of the burn accidents occurred indoors. Scalding was the main mechanism for hand burns. There was an adult nearby in 71.9% of the patients. Among patients with hand involvement, 19 (21.35%) were considered as neglect. All the neglect cases were under the age of 6.
CONCLUSION: Pediatric burn accidents occurred mainly at home, mostly with an adult around. Habits of drinking hot beverages, dangerous cooking practices and lack of awareness are some important issues leading to burn accident. Neglect is found in 21.35% of hand burns as the etiology. In addition to general preventive measures special attention should be paid to the signs of neglect in the evaluation of patients. These burns should also be reported to official services, as they may reflect inadequate supervision or neglect by the caregiver.