Surgical management of paediatric burns in northern Tanzania

Mohammed Farid 1, Emmanuel Manjira 2, Jeremy Rawlins 3

1 Department of Plastic Surgery, The Royal London Hospital NHS Trust, Whitechapel Road, London, United Kingdom, E1 1BB   e-mail: mohammed.farid@gmail.com
2 Department of Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania     e-mail: e.manjira@yahoo.com

3 Department of Plastic Surgery, Royal Perth Hospital, Goderich Street, Perth WA 6000, Australia    e-mail:  jeremy_rawlins@hotmail.com

Introduction

Paediatric burns in sub-Saharan Africa lacks appropriate first aid, prevention strategies or long -term care.  There was no accurate data reflecting the magnitude of burns morbidity in the paediatric Tanzanian population. The aim was to capture the scale of debilitating burn injuries presenting few year after the initial insult. Our international team delivered reconstructive surgical care for severe paediatric burns contracture.

Methods

A retrospective review of paediatric burns who underwent surgical management (June 2013 – November 2015) for severe burn contractures at least one year after initial injury. A thorough assessment was performed for release and reconstruction (full thickness skin graft FTSG, Split thickness skin graft STSG, transposition flap, Z – plasty).  Exclusion criteria included immature scar requiring further rehabilitation or unfit for a general anaesthetic.

Results

Nineteen children were included (9 male , 10 female) . Average age was 8 years (Range 2-16).  Burns scar reconstructed with 9 full thickness skin grafts, 6 split thickness skin grafts, 3 transposition flaps, 7 Z-plasties either alone or in combination. Reconstruction was primarily for functional reasons over joints or head and neck. Children remained in hospital until first graft check and had appropriate rehabilitation prior to discharge.

Conclusion 

The long term morbidity of paediatric burns in northern Tanzania presented with severe contractures required complex reconstruction. Our goal was to prevent future disability and promote healthy growth for this group. Nevertheless, a greater emphasis should be placed on prevention strategies and primary burns care to prevent debilitating contractures.

Key Words

Paediatric, Africa, Burns Care

Biography

I graduated with MBChB from the university of Birmingham , England in 2009. Subsequently, i did my plastic surgery theme core training in Yorkshire region till 2013. During this time, i achieved an MSc in surgical sciences with University of Edinburgh . I have been a registrar in plastic surgery for 10 months and aim to pursue a career in burns. I spend my free time travelling, cycling, reading and keeping fit.

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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