Analysis of the epidemiological characteristics and prevention and treatment of forty-nine neonatal burn patients in the south region of Henan province

Objective To explore the epidemiological characteristics and prevention strategy of neonatal burns in southern Henan province. Methods From February 1967 to May 2018, a total of 49 cases of neonatal burns were admitted to the burn center of the 159th Hospital of People′s Liberation Army, aged 0-28 (3.57±7.35) days, 28 cases of male and 21 cases of female, with total 1%-46% (8.66±7.29)% total body surface area (TBSA) burns including superficial Ⅱ degree (4.23±3.79)%TBSA, deep partial-thickness burn (7.29±6.71)%TBSA, and full thickness burn (5.73±5.05)%TBSA. The average time from injury to admission was (2.79±4.40) days. While admission, there were 4 cases with moderate shock and 6 cases with inhalation injury. There were 7 cases of neonatal asphyxia, 2 cases of neonatal hard swelling and 1 case of hydrocephalus. All of the cases were collected and retrospectively analyzed. According to the admission time, the cases were divided into 3 groups, 1960s-1970 s, 1980s-1990 s, and 2000s-2010 s. And their causes, injured body parts, burn area, the times of operation, hospitalization time, complications and prognosis were comparatively analyzed. Data were processed with one-way analysis of variance, chi-square test and Fisher′s exact test. Results Hot liquid scald accounted for 57.14% of the total number of cases, 26.53% of burns caused by flame, and 6.12% of cases by neonatal thermostat. Compared with the ages, the number of thermal scald increased, and the number of flame burns decreased (with P values below 0.05). The proportion of iatrogenic factors increased year by year (P<0.05). Neonatal burns were mostly injured in head, neck, trunk and limbs, while hip, perineal, digestive tract and inhalation injuries were rare, with no significant difference in the different ages (with P values above 0.05). There were no remarkable differences in burn area and burn areas of different degrees of burn among the newborns of the different ages (with P values above 0.05). The total number of operations were close, but the number of hospitalization days was gradually reduced (P<0.05). Hypoalbuminemia, electrolyte imbalance disorder and diarrhea were the most common complications in neonates. Sepsis and death rate were significantly reduced (with P values below 0.05). The total cure rate was 91.84%. Conclusions To improve the national awareness of burn prevention and first aid, standardize the nursing process of newborn babies, and reduce iatrogenic burns are the fundamental solving ways. The application of new technologies such as hemodynamic monitoring, multidisciplinary cooperation, NPWT and MEEK skin grafting are key measures for the treatments of severely burned neonates. Key words: Infant, newborn; Burns; Epidemiologic studies; Iatrogenic desease