Outpatient Management of Pediatric Burns in Chile

Abstract

ABSTRACT

Most burn injuries can be treated on an outpatient basis. However, data on burn injuries treated at outpatient centers are largely omitted from the burn literature. Patients suitable for pediatric outpatient burn care are mostly children younger than 5 years old at the time of the injury, with the hand as the prevalent burn location and total body surface area of <1%. The main causal agent in this population are scalds and hot objects, and patients have an average healing time of 13 days. The hospitalization rate varies from 1% to 6%. The success of ambulatory care depends on careful patient selection. The criteria for outpatient management can vary based on the center’s experience and resources and mainly involve partial thickness burns affecting <5% of the total body surface area and burns with minimal involvement of special areas. A careful review of the patient’s social and economic situation is an essential component of the assessment for successful outpatient burn care, as the child’s family should be able to support the wound care, attend to follow-up consultation, and have access to transportation for timely access to a specialized burn center. The treatment goal should be to close the burn wounds as soon as possible. The outpatient care strategy should include adequate pain management, local wound care, home instructions, and follow-up until the burn wounds are well reepithelialized. The most important potential complication is wound infection. It is relevant to know the symptoms and signs of local and systemic infection, so that infections can be treated in a timely and adequate manner. At our outpatient burn center in Chile, we can successfully manage 85% to 90% of patients with burns by making adequate patient selection, having an outpatient management strategy that includes family education, and knowing the possible complications.