Thermal injuries in under - 4 year old children: the Lesotho experience

Abstract

The Queen Elizabeth II Hospital is the apex of the health care services in the Kingdom of Lesotho but has no designated burns unit. A review of patient managed during a 5- year period was done to document our experience so as to show what can be achieved even without a standard burns’ unit. We reviewed the clinical course of children who were admitted for care of acute thermal injuries during a 5-year period, May 1997 to April, 2002 inclusive. All were treated in the children surgical ward in accordance with a protocol of care emphasizing urgent care of shock, accurate fluid therapy, open wound care and early enteral feeding. Ninety-eight children (51 males and 4 7 females) aged 4 months to 43 months (mean 21.66 ± 1 1.30 months) were admitted on account of acute thermal injuries during the study period. The injuries included scalding (46%) involving predominantly the upper part of the body and full thickness burns (87%). Skin grafting was needed in 82% of the patients. The common complications were infection fluid imbalance respiratory problems, and contracture deformities. The mean duration of hospital stay was 4 0 ± 4.43 days and the ease fatality rate was 9%. The case fatality rate in this series is considered high and could be improved if there were a well-staffed specialized burns unit.