Challenging scar management after a neonatal burn

Mrs Fiona Willington1

1Sydney Children’s Hospital

Challenging scar management for a contact thermal burn injury in a newborn infant.

Thermal injuries to neonates are fortunately rare events. Therefore, there is limited published information on successful scar management options to assist with achieving optimal results for these patients.

This baby was referred at 2 weeks of age for Physiotherapy and scar management of a burn injury. The child had sustained a burn injury after contact with a heated object in the delivery suite in the immediate time post delivery. The child was born at full term, with a birth weight in the 25th percentile, with APGARS of 9 and 9. The initial injury was assessed as superficial but later confirmed as full thickness with an approximate size of 2% TBSA. The wound took 30 days to heal, without grafting.

While only involving a small burn surface area this injury was challenging to effectively manage due to the very young age of the baby and the location on the infant’s buttock. The skin was extremely sensitive and delicate, further compounded by the location under the infant’s nappy. Unable to use pressure garments or contact media the best treatment options were silicone creams, barrier dressings and thin silicone tapes. After a year of treatment the scar appearance is much improved with a pale and flat appearance and mildly thickened texture. The child is also well with a normal development.

Fiona completed her undergraduate training in Physiotherapy at the University of South Australia. Followed by a Masters Degree in Physiotherapy at the University of South Australia, with Paediatric component through Charles Sturt University.

Fiona currently works as the primary Physiotherapist in the Burns Clinic at Sydney Children’s Hospital, Randwick. This hospital is part of the Sydney Children’s Hospital Network and provides care to children with burns with small surface area.

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