ORAL COMMISSURE BURNS IN CHILDREN

Electrical burns of the mouth are relatively common in young children. Early intervention to prevent complications remains controversial. A chart review was conducted of 24 patients with oral commissure burns w ho were treated at the University of Iowa from 1975 to 1988. All of th ese patients were treated conservatively without splinting or early su rgery. Only one patient underwent oral splinting before receiving care at the University of Iowa Hospitals and Clinics. While under our care , no patients suffered significant hemorrhage at eschar separation. Co mmissuroplasty and/or reconstructive lip surgery were performed at var ious times after the burn injury was healed and the functional or aest hetic impairment was established. Long-term follow-up was from 5 to 17 years, allowing for longitudinal evaluation of the postburn scars and their influence on facial growth. Our review revealed that (1) younge r children with more severe burns have a less favorable outcome; (2) n o hemorrhage was observed immediately after the burn or at eschar sepa ration; and (3) conservative surgical treatment after scar maturation- and in some cases following steroid injections-resulted in a successfu l functional and esthetic outcome.