Diarrhoea in major paediatric burns: a clinical challenge

Mr Silas Nann1, Dr Edward Gibson1, Mr Darren Molony1, Dr Michelle Lodge1, Dr Rebecca Cooksey1, Dr Amy Jeeves1, Ms Linda Quinn1, Mr Bernard Carney1

1Women’s And Children’s Hospital, North Adelaide, Australia

Diarrhoea is a near universal problem in major paediatric burns and can impact dressing integrity, contaminate burn wounds and impair nutrition. Past research suggests multiple factors may be responsible for causing diarrhoea in this population and infectious organisms are often not identified. This study aims to further define the prevalence of the problem and evaluate our current understanding of diarrhoea in major paediatric burns and the strategies to manage this problem.


A retrospective audit of all major burns, TBSA >30%, managed by the burns unit between January 2000 and March 2016 was undertaken. Case notes and online records were reviewed looking for the presence of diarrhoea, duration of the illness and contributing factors such as positive stool cultures or commencement of nasoenteric feeds. Literature review was also completed.

The majority of patients in the study suffered from variable degrees of diarrhoea. Whilst there was a tendency towards protracted diarrhoea, there was no consistency in length, nor of exposure to causative factors. A number of patients did have stool samples positive for bacterial or viral infection.


The study is consistent with other research suggesting that diarrhoea in major paediatric burns is a near universal issue without a clear aetiology. It does create a significant burden for the patient and treating unit and, whilst multiple strategies have been trialled, a definitive management plan remains elusive. This study contributes to the growing research in this area and provides an important overview of our understanding of diarrhoea in major paediatric burns.

Silas Nann is a medical student at the University of Adelaide who has a keen interest in burns and plastic surgery


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