The child’s hand was burned and his fingers were stuck together

Lele (pseudonym), who had just turned one year old, was playing at home. Her mother boiled a pot of boiling water and put it on the table. , and then went to do other housework. Lele looked curious and put his left hand into the boiling water. Then there was a heartbreaking cry, and Lele’s mother rushed over. At that time, her mother was so anxious that she didn’t know what to do. There was no treatment at home, so the child was rushed to the emergency center of the local county hospital in Anhui. According to family members, after Lele’s local treatment, the effect was not satisfactory and she felt that her hand function was affected.

The child developed scar contracture sequelae of her left hand. Except for the thumb, the other four fingers of her left hand were glued together. The scar was yellow-white, cord-shaped, and webbed. In addition, the tips of her little fingers were damaged.

Perform scar release surgery and then take skin grafts

Scar contracture will affect the function and appearance of the hand. Since the child is very young, if the surgery is not performed in time, it may also affect the future of the hand. development. At the end of June this year, experts successfully performed scar release and free skin grafting on the child's left hand. During the operation, experts opened the contracture scar on the child's left hand to form a wound, and then took skin from the groin area and transplanted it to the hand. Although the operation time is not long, only 1 hour, the operation requirements are high. Since the child is small and the wound area is small, the operation must be precise. At present, the child Lele's hand is recovering well and he will be discharged from the hospital next week.

Immerse the affected area in cold water as soon as possible after a burn.

Summer is the season with the highest incidence of burns in children. Children aged 1.5 to 5 years old are lively and curious, and lack foresight of danger, which makes them prone to burns. The main target of burns. Most children accidentally knock over hot water bottles, soup bowls, etc. at home and are burned by boiling water or hot soup.

Being considerate parents is the greatest guarantee for effectively preventing burns in children. When taking a bath, pay attention to the order of pouring water, first put cold water, then hot water; be careful not to place the hot water bottle at home where children can reach it. After a child is burned, parents are often confused and rush to send the child to the hospital without knowing much about emergency measures. In fact, if timely measures can be taken to cool down, reduce swelling and relieve pain, the child's injury can be better recovered.

If a child is burned by boiling water or steam, the affected area should be immersed in cold water as soon as possible, or rinsed with running water to promote local heat dissipation and prevent blisters. After cooling down, apply burn ointment if needed. Do not rely solely on methods such as applying soy sauce. To avoid infection, it is best to go to the hospital for further treatment to avoid delaying the condition.

Causes of burns in children

Common causes of burns in children:

1. Skin contact with hot objects or liquids

Most common in 3 Children under the age of 18 who have preliminary mobility such as walking are exposed to uncooled meals, boiling water, hot pots, electric cups, etc. The boundary between the burn site and normal tissue is relatively clear.

2. Contact with open flames

It is more common in children over 2 years old. They are burnt after being exposed to stove fire, matches, or flammable objects without protection. The boundaries of the injury are usually unclear. .

3. Burns during explosions

Rare and seen in fireworks accidents. The degree of burns in the injured area is relatively uniform.

4. Electrical injury

Rare and seen in lightning injuries or contact with high-voltage electricity.

Clinical manifestations of burns

1. Local and systemic changes of burns

The degree of burns in children depends on the way of the burn and the area of ??the burn. Its pathological changes and clinical manifestations are mainly reflected in both local tissue and systemic changes.

(1) Local changes: After the skin is exposed to high heat (over 60°C), the proteins in the tissue can coagulate, causing cell necrosis. Local reactions vary depending on the temperature of the object, duration of contact, and thickness of the injured skin. Generally, blisters occur when the skin comes into contact with hot objects at 70°C for 1 second, but newborns are often scalded by hot water bottles at 50°C. Pediatric burns are also divided into 3 degrees according to the depth of local tissue necrosis. However, because children's skin is very thin, it is difficult to measure. General clinical experience is prone to underestimation.

(2) Systemic changes: Severe burns may cause shock. Shock that occurs early after burns is mostly caused by pain and mental stimulation, and is generally temporary and not serious. Secondary shock is caused by increased capillary leakage, resulting in tissue edema and large amounts of wound exudation, plasma loss, hemoconcentration and reduced circulating blood volume, followed by tissue hypoxia, decreased blood pressure, weak pulse, hyponatremia and Acidosis, oliguria or anuria, etc. The fluid oozes out fastest within 6 to 8 hours after a burn, reaches its peak at 36 to 48 hours, usually exceeds the lymphatic return capacity, and then gradually slows down.

2. Calculation of burn area

When observing burns, attention should be paid to a detailed understanding of the area and depth of the injury, including special parts such as facial features, joints, and face. Accurately calculating the burn area and estimating the depth can help determine the severity of the injury, estimate the prognosis, and facilitate treatment. It is also the basis for fluid replenishment. The calculation of the burn area is as follows:

(1) Palm method: The area of ??the injured person’s palm when his fingers are put together is equivalent to 1% of the total body surface area.

This method is slightly less accurate and is often used in emergency rooms to estimate small area burns or to estimate small area 3rd degree burns.

(2) Body surface area calculation method: Calculate with reference to the area percentage of each part of the child's body at different ages. This method is more accurate. However, the younger the child, the larger the proportion of the head and the smaller the proportion of the lower limbs. As age increases, the ratio of children's head to lower limbs gradually approaches that of adults.

You can refer to the following formula for correction: Children’s head area (%) = 9 + (12-age) Children’s lower limb area (%) = 41- (12-age).

3. Estimation of burn depth

The "three degrees and four points" method is usually used for clinical evaluation. In the early stages of burns, it is difficult to accurately judge the depth of burns, especially when the boundary between deep second-degree burns and third-degree burns is easily confused. Therefore, recheck the correction 48 hours after treatment; the skin on the palms and soles is thick, and it is easy to mistake the second degree for the third degree in the early stage. However, the skin of infants and young children is very thin, and it is easy to mistake the third degree for the second degree, so you should pay attention to it.