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      Neonatal Burn Injuries Managed in a Neonatal Intensive Care Unit of a Tertiary Hospital in North-Central Nigeria

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          Abstract

          Introduction:

          Neonatal burn injuries are rare in clinical practice. This explains the many case reports of such injuries. This is a report of our experience in the management of neonatal burn injuries in our centre.

          Materials and Methods:

          This is a retrospective study of neonatal burn injuries that were managed over an eight year period (2014–2022). The information that was retrieved from the case notes included the socio-demographic data, birth weight, weight at admission, type of injury, total burn surface area (TBSA), depth of burn injury, type of treatment, length of hospital stay and outcome of care. The data were then entered into the SPSS version 25 (IBM Corp., United States) software and analysed.

          Results:

          We managed 11 neonates, five males and six females with a male: female (M: F) ratio of 1:1.2. Their age ranged from zero to 25 days with a median (IQR) of 2 (1 -15) days. Eight (72.7%) of them were one to two days old and eight (72.7%) were admitted as out born. Majority (81.8%) of the mothers were primiparous women. Nine (81.8%) of the injuries were as a result of hot water bath. Most (66.6%) of these baths were done by the grandmothers or mothers of the babies. The total burn surface area (TBSA) ranged from 1% to 62%, with a median (IQR) of 11 (7.5 – 19.0). None of the babies had skin grafting. The length of stay (LOS) ranged from six days to 25 days with a median (IQR) of 11.0 (7.0 – 16.0) days. Only one baby died giving a hospital mortality rate of 9.1%.

          Conclusions:

          The commonest cause of neonatal burn injury in this series is scald injuries from hot water bath. Providing education about safe bathing to caregivers should be included in routine antenatal and postnatal instructions in order to prevent burns.

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          Most cited references33

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          Epidemiology of burns throughout the world. Part I: Distribution and risk factors.

          M Peck (2011)
          Globally in 2004, the incidence of burns severe enough to require medical attention was nearly 11 million people and ranked fourth in all injuries, higher than the combined incidence of tuberculosis and HIV infections. Fortunately, although burns and fires account for over 300,000 deaths each year throughout the world, the vast majority of burns are not fatal. Nonetheless, fire-related burns are also among the leading causes of disability-adjusted life years (DALYs) lost in low- and middle-income countries (LMIC). Morbidity and mortality due to fire and flames has declined worldwide in the past decades. However, 90% of burn deaths occur in LMIC, where prevention programs are uncommon and the quality of acute care is inconsistent. Even in high-income countries, burns occur disproportionately to racial and ethnic minorities such that socioeconomic status--more than cultural or educational factors--account for most of the increased burn susceptibility. Risk factors for burns include those related to socioeconomic status, race and ethnicity, age, and gender, as well as those factors pertaining to region of residence, intent of injury, and comorbidity. Both the epidemiology and risk factors of burns injuries worldwide are reviewed in this paper. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.
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            Recent trends in burn epidemiology worldwide: A systematic review.

            Burns have been more prevalent among low socioeconomic populations and in less developed regions. Incredible advances in burn care and social development over the recent decades, however, should have placed the incidence and severity of burns in a downwards trend. The aim of this review was to give an overview on current trends in burn epidemiology across the world. Also the socioeconomic development in countries that have published epidemiological data used in this study has been taken into account when comparing the results. There was a worldwide downwards trend of burn incidence, burn severity, length of hospital stay, and mortality rate. These findings were particularly pronounced in very highly developed countries. Data from highly and medium developed countries were more heterogeneous. No studies could be obtained from low and middle income countries. Comparisons between the different studies were compromised by the fact that studies emerged from specialized facilities on one hand and general hospitals on the other. Analyzed studies were also frequently focusing on limited patient populations such as "children" or "elderly". Our findings indicate the need for an international burn database with a minimal data-set in order to obtain objective and comparable results in respect of burn epidemiology.
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              Skin Physiology of the Neonate and Infant: Clinical Implications.

              Significance: The skin is a complex and dynamic organ that performs several vital functions. The maturation process of the skin starts at birth with the adaption of the skin to the comparatively dry environment compared to the in utero milieu. This adaptive flexibility results in the unique properties of infant skin. To deliver appropriate care to infant skin, it is necessary to understand that it is evolving with unique characteristics. Recent Advances: The role of biophysical noninvasive techniques in the assessment of skin development underlines the importance of an objective evaluation of skin physiology parameters. Skin hydration, transepidermal water loss, and pH values are measurable with specific instruments that give us an accurate and reproducible assessment during infant skin maturation. The recording of these values, following standard measurement procedures, allows us to evaluate the integrity of the skin barrier and to monitor the functionality of the maturing skin over time. Critical Issues: During the barrier development, impaired skin function makes the skin vulnerable to chemical damage, microbial infections, and skin diseases, possibly compromising the general health of the infant. Preterm newborns, during the first weeks of life, have an even less developed skin barrier and, therefore, are even more at risk. Thus, it is extremely important to evaluate the risk of infection, skin breakdown, topical agent absorption, and the risk of thermoregulation failure. Future Directions: Detailed and objective evaluations of infant skin maturation are necessary to improve infant skin care. The results of these evaluations should be formed into general protocols that will allow doctors and caregivers to give more personalized care to full-term newborns, preterm newborns, and infants.
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                Author and article information

                Journal
                J West Afr Coll Surg
                J West Afr Coll Surg
                JWACS
                Journal of the West African College of Surgeons
                Wolters Kluwer - Medknow (India )
                2276-6944
                Jan-Mar 2023
                18 January 2023
                : 13
                : 1
                : 84-90
                Affiliations
                [1] Department of Surgery, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
                [1 ] Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
                [2 ] Department of Paediatrics, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
                [3 ] Department of Plastic Surgery, Prince Mishari bin Saud Hospital, Baljurashi, Bahah Region, Kingdom of Saudi Arabia
                [4 ] Department of Surgery, Federal Medical Centre, Azare, Nigeria
                [5 ] Department of Surgery, Dalhatu Araf Specialist Hospital, Lafia, Nigeria
                Author notes
                Address for correspondence: Prof. Simon J. Yiltok, Department of Surgery, University of Jos/Jos University Teaching Hospital, Jos, Nigeria. E-mail: simyiltok@ 123456yahoo.com
                Article
                JWACS-13-84
                10.4103/jwas.jwas_214_22
                10010592
                36923811
                9d2c208d-aa22-42af-87b3-fbde70fef8b7
                Copyright: © 2023 Journal of West African College of Surgeons

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 27 September 2022
                : 28 October 2022
                Categories
                Original Article

                burn injury,hot water bath,neonate,scald
                burn injury, hot water bath, neonate, scald

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