Ashes, embers, and coals: Significant sources of burn-related morbidity in children

Burn injuries remain the leading source of pediatric morbidity and mortality, with burns to the feet presenting unique management challenges. Characterization of the etiology of these burns may identify strategies for injury prevention. A retrospective review of pediatric patients with isolated foot burns was performed. Between September 1992 and February 2006, 155 patients were admitted with isolated foot burns. The majority (69%) of these injuries resulted from walking on hot ashes, with the remainder being from scald, flame, or contact burns. The median percent TBSA burned was similar in ash and nonash burns, but median LOS was 1 day less in ash burns. Children with ash burns were significantly older and less likely to have full thickness burns than children with nonash burns. Patients with ash burns were also less likely to require excision and grafting than those who were burned by other mechanisms. Both short and long-term complications were infrequent. Although ash burns tend to be more superficial than burns of other etiologies and are associated with a shorter length of stay, they often require surgical intervention. Because of their relative frequency and severity, ash burns to the feet warrant attention as an area for preventive focus.