LONG-TERM FUNCTIONAL SEQUELAE AFTER PEDIATRIC BURNS

Ninety-one patients with at least 5 per cent (median 10 per cent, maxi mum 50 per cent) total body surface area (TBSA) burns were clinically re-examined on average 17.3 yr after primary injury. The patients had sustained mostly superficial dermal scalds. The most common long-term functional sequelae were impaired tanning (n = 67; 77.7 per cent), dim inished tactile sensibility (n = 50; 56.2 per cent) and increased redd ening (n = 14; 15.6 per cent) either in the sun or the Finnish sauna. Five patients (6.3 per cent) had limited joint mobility and one patien t experienced constrictive scars on her trunk during pregnancy. Scar a ppearance was significantly associated with impaired tactile sense (ch i(2) = 11.87, DF = 2, p<0.01; Spearman's R = 0.27, p = 0.03). Surprisi ngly, better scar appearance showed more disturbed touch sensation. Th e primary operative treatment (early excision and split skin grafting) was not associated with diminished sense of touch (chi(2) = 1.24, DF = 1,p = 0.27). Neither were scar appearance and poor tanning significa ntly associated (chi(2) = 1.63, DF = 1, p = 0.4). Only three patients suffered no functional detriments. In this series the harmful function al consequences were generally slight. The aetiological background (sc alds) and the relatively small, superficially burned skin area probabl y explains the good late outcome. However, since nearly every burn-inj ured child will have some signs of the injury in adulthood, children p resent a constant challenge in the effort for better burn care and pre vention. (C) 1998 Elsevier Science Ltd for ISBI. All rights reserved.