The experience of critical burn injury treatment in pediatric practice

Patients with severe burn injuries require specialized medical care. For many decades, burn injury in children remains an important issue both in medical and social-economic aspects. It is explained by the high frequency of this pathology, prevalence among all age groups of the population, severe clinical course accompanied by the multiple organ failure development. About 400 thousand burns per year occur in Russia, 35–40% of them affect children. A burn injury often leads to fatal outcome, disability and reduce of the quality of life. Wound infection associated with the burn injury in children remains a topical problem of modern combustiology. The authors present the clinical case of successful treatment of Patient M., born in 2005. The patient was transferred from the city M. to the burn center of University Clinic of the Privolzhsky Research Medical University in Nizhny Novgorod on the third day after getting the injury. During the hospitalization period in the burn center, the patient underwent complex treatment: infusion-transfusion therapy under the hemodynamic and laboratory indicators control, antibacterial and anticoagulant therapy, nutritional support by a combined method, symptomatic treatment, active surgical tactics (necrectomy by bordering incisions using modern wound hydrocolloid coatings, autologous skin grafting). In skin grafting operations, a high perforation coefficient of split grafts was used (1:6, 1:3). The success of treatment was determined by the creation of an optimal wound environment for the autografts’ engraftment, the absence of regression, which made it possible to restore the skin integrity in a short time, and to avoid complications of the burn disease course. Thus, the early transfer of a child with a severe injury into a specialized burn center, intensive therapy, active surgical tactics, the use of modern wound coatings in the treatment of a patient with a critical area of deep burn injury made it possible to successfully restore the skin in a short time of hospitalization.