Las quemaduras en la población pediátrica colombiana: del desconocimiento hacia la prevención
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oct. 1, 2016
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DOI: 10.1016/j.rcpe.2016.09.001
El traumatismo es un problema de salud pública en todo el mundo y debe ser reconocido como un evento predecible y por ende prevenible. Las lesiones térmicas o quemaduras son uno de los peores traumatismos a los que un individuo puede estar expuesto. Las quemaduras fatales contribuyen en gran parte a la mortalidad de los países en desarrollo y son la tercera causa de muerte traumática de la población pediátrica mundial. Además, las lesiones no fatales tienen devastadores efectos fisiopatológicos que, junto con las secuelas físicas y psíquicas, producen discapacidad prolongada o permanente que afecta a la calidad de vida de los sobrevivientes.
La clave para disminuir la morbimortalidad asociada a las quemaduras es la prevención. Es necesario establecer datos estadísticos confiables que determinen los grupos, características y regiones de mayor riesgo; además de diseñar e implementar intervenciones efectivas y de impacto en la población pediátrica y en los responsables del cuidado de los niños, todo esto con el fin de generar programas de prevención. Este artículo de opinión discute aspectos importantes acerca de cómo evitar las quemaduras, además de informar y complementar los resultados de un reciente estudio que caracteriza las muertes por quemaduras en Colombia. Finalmente, propone una intervención educativa, con el firme objetivo de sensibilizar a la población en general sobre la gravedad de este problema y la necesidad de disminuir el número de niños quemados en nuestro país.
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Aldana, M. C. del R., Castellanos, L. F., Osorio, L. Q., & Navarrete, N. (2016). Las quemaduras en la población pediátrica colombiana: del desconocimiento hacia la prevención. Pediatría, 49(4), 128–137. Recuperado a partir de https://revistapediatria.org/rp/article/view/11
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10. C.A. Cassiani,A.M. Cubides,Ángela,M.T. Borrero,W. Marimón Alcohol y trauma: Un problema prioritario de salud pública Salud Uninorte., 28 (2012), pp. 131-149
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13. A. Parbhoo,Q.A. Louw,K. Grimmer-Somers Burn prevention programs for children in developing countries require urgent attention: A targeted literature review Burns., 36 (2010), pp. 164-175 http://dx.doi.org/10.1016/j.burns.2009.06.215 Medline
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23. E.B. Wilson,J.G. McCormack Trauma and burns in children Anaest Intens Care Med., 13 (2012), pp. 31-36
24. C. Vivó,R. Galeiras,M.D. Del Caz Initial evaluation and management of the critical burn patient Med Intensiva., 40 (2016), pp. 49-59 http://dx.doi.org/10.1016/j.medin.2015.11.010 Medline
25. C. Porter,D.N. Herndon,L.S. Sidossis,E. Børsheim The impact of severe burns on skeletal muscle mitochondrial function Burns., 39 (2013), pp. 1039-1047 http://dx.doi.org/10.1016/j.burns.2013.03.018 Medline
26. B.S. Atiyeh,S.A. Dibo,A.E. Ibrahim,E.R. Zgheib Acute burn resuscitation and fluid creep: it is time for colloid rehabilitation Ann Burns Fire Disasters., 25 (2012), pp. 59-65 Medline
27. A.D. Rogers,J. Karpelowsky,A.J. Millar,A. Argent,H. Rode Fluid creep in major pediatric burns Eur J Pediatr Surg., 20 (2010), pp. 133-138 http://dx.doi.org/10.1055/s-0029-1237355 Medline
28. P. Hodgins,P. Hodgins,T. Potokar,P. Price Comparing rich and poor: Burn prevention in Wales, Pakistan, India, Botswana and Zambia Burns., 37 (2011), pp. 1354 1359 http://dx.doi.org/10.1016/j.burns.2011.07.001 Medline
29. D.N. Herndon,D. Gore,M. Cole,M.H. Desai,H. Linares,S. Abston Determinants of mortality in pediatric patients with greater than 70% full thickness total body surface area treated by early excision and grafting J Trauma., 27 (1987), pp. 208-212 Medline
30. T.T. Nguyen,D.A. Gilpin,N.A. Meyer,D.N. Herndon Current treatment of severely burned patients Ann Surg., 223 (1996), pp. 14-25 Medline
31. O.A. Olawoye,A.O. Iyun,S.A. Ademola,A.I. Michael,O.M. Oluwatosin Demographic characteristics and prognostic indicators of childhood burn in a developing country Burns., 40 (2014), pp. 1794-1798 http://dx.doi.org/10.1016/j.burns.2014.04.008 Medline
32. B.S. Atiyeh,M. Costagliola,S.N. Hayek Burn prevention mechanisms and outcomes: Pitfalls, failures and successes Burns., 35 (2009), pp. 181-193 http://dx.doi.org/10.1016/j.burns.2008.06.002 Medline
33. H. Sadeghi-Bazargani,R. Mohammadi,S. Amiri,N. Syedi,A. Tabrizi,P. Irandoost Individual-level predictors of inpatient childhood burn injuries: a case–control study BMC Public Health., 16 (2016), pp. 1-9 http://dx.doi.org/10.1186/s12889-015-2639-8 Medline
34. N. Alharthy,M. Al Mutairi,S. AlQueflie,A.B. Nefesa,N.B. Manie,S.B. Nafesa Pattern of burns identified in the Pediatrics Emergency Department at King Abdul-Aziz Medical City: Riyadh J Nat Sci Biol Med., 7 (2016), pp. 16-21 http://dx.doi.org/10.4103/0976-9668.175019 Medline
35. R. Spiwak,R. Lett,L. Rwanyuma,S. Logsetty Creation of a standardized burn course for Low Income Countries: Meeting local needs Burns., 40 (2014), pp. 1292-1299 http://dx.doi.org/10.1016/j.burns.2014.01.007 Medline
36. C. Mock,M. Peck,E. Krug,M. HaberalConfronting the global burden of burns: a WHO plan and a challenge Burns., 35 (2009), pp. 615-617 http://dx.doi.org/10.1016/j.burns.2008.08.016 Medline
37. S.N. Forjuoh Burns in low-and middle-income countries: a review of available literature on descriptive epidemiology, risk factors, treatment, and prevention Burns., 32 (2006), pp. 529-537 http://dx.doi.org/10.1016/j.burns.2006.04.002 Medline
38. F. Verey,M.D. Lyttle,Z. Lawson,R. Greenwood,A. Young When do children get burnt Burns., 40 (2014), pp. 1322-1328 http://dx.doi.org/10.1016/j.burns.2014.01.010 Medline
39. F. Cardona,A. Echeverri,J.F. Forero,C.A. García,C.M. Gómez,C.P. Gómez Epidemiología del trauma por quemaduras en la población atendida en un hospital infantil. Manizales 2004-2005 Rev Fac Med., 55 (2007), pp. 80-95
40. M.A. Hoyos,N.C. Jaramillo,M.E. Molina,S. Valverde,S. Ospina Epidemiological and clinical profile of burn victims Hospital Universitario San Vicente de Paúl, Medellín, 1994-2004 Burns., 32 (2006), pp. 1044-1051 http://dx.doi.org/10.1016/j.burns.2006.03.023 Medline
41. M.F. Sierra-Zúñiga,O.E. Castro-Delgado,J.C. Caicedo-Caicedo,Á.M. Merchán-Galvis,M. Delgado-Noguera Epidemiological profile of minor and moderate burn victims at the University Hospital San José, Popayán, Colombia, 2000-2010 Burns., 39 (2013), pp. 1012-1017 http://dx.doi.org/10.1016/j.burns.2012.11.007 Medline
42. K. Peleg,S. Goldman,F. Sikron Burn prevention programs for children: do they reduce burn-related hospitalizations Burns., 31 (2005), pp. 347 350 http://dx.doi.org/10.1016/j.burns.2004.10.028 Medline
43. S.R. Gimeniz-Paschoal,D.M. Pereira,N.E. Nascimiento Efect of an educative action on relatives’ knowledge about childhood burns at home Rev Lat Am Enfermagen., 17 (2009), pp. 341-346
44. T. Tse,C.H. Poon,K.H. Tse,T.K. Tsui,T. Ayyappan,A. Burd Pediatric burn prevention: An epidemiological approach Burns., 32 (2006), pp. 229-234 http://dx.doi.org/10.1016/j.burns.2005.08.025 Medline
2. Peden M, Oyegbite K, Ozanne-Smith J, Hyder AA, Branche C, Rahman AKMF, et al. editores. World report on child injury prevention. Geneva: World Health Organization; 2008.
3. M.C.R. Aldana,N. Navarrete Epidemiology of a decade of pediatric fatal burns in Colombia, South America Burns., 41 (2015), pp. 1587-1592 http://dx.doi.org/10.1016/j.burns.2015.05.005 Medline
4. P. Davoodi,J.M.O.S.J. Fernandez Postburn sequelae in the pediatric patient: clinical presentations and treatment options J Craniofac Surg., 19 (2008), pp. 1047-1052 http://dx.doi.org/10.1097/SCS.0b013e318175f4df Medline
5. P. Agbenorku,M. Agbenorku,P.K. Fiifi-Yankson Pediatric burns mortality risk factors in a developing country's tertiary burns intensive care unit Int J Burn Trauma., 3 (2013), pp. 151-158
6. M.T. Rosanova,D. Stamboulian,R. Lede Long term mortality in burned children Transl Pediatr., 4 (2015), pp. 203-205 http://dx.doi.org/10.3978/j.issn.2224-4336.2015.06.03 Medline
7. J.A. Waller Injury control: A guide to the causes and prevention of trauma Lexington Books, (1985)
8. K. Hofman,A. Primack,G. Keusch,S. Hrynkow Addressing the growing burden of trauma and injury in low- and middle-income countries Am J Public Health., 95 (2005), pp. 13-17 http://dx.doi.org/10.2105/AJPH.2004.039354 Medline
9. G.C. Patton,C. Coffey,S.M. Sawyer,R.M. Viner,D.M. Haller,K. Bose Global patterns of mortality in young people: a systematic analysis of population health data Lancet., 374 (2009), pp. 881-892 http://dx.doi.org/10.1016/S0140-6736(09)60741-8 Medline
10. C.A. Cassiani,A.M. Cubides,Ángela,M.T. Borrero,W. Marimón Alcohol y trauma: Un problema prioritario de salud pública Salud Uninorte., 28 (2012), pp. 131-149
11. The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020,
12. C.J.L. Murray,A.D. Lopez Alternative projections of mortality and disability by cause 1990-2020: Global burden of disease study Lancet., 349 (1997), pp. 1498-1504 http://dx.doi.org/10.1016/S0140-6736(96)07492-2 Medline
13. A. Parbhoo,Q.A. Louw,K. Grimmer-Somers Burn prevention programs for children in developing countries require urgent attention: A targeted literature review Burns., 36 (2010), pp. 164-175 http://dx.doi.org/10.1016/j.burns.2009.06.215 Medline
14. Injury prevention: General principles. in TEACH-VIP (Training, Educating, and Advancing Collaboration in Health on Violence and Injury Prevention) E-Learning. Geneva: World Health Organization; 2010 [citado 22 Feb 2016]. Disponible en: http://teach-vip.edc.org/course/index.php?lang=en_utf8
15. National Action Plan for Child Injury Prevention. Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2012 [citado 25 Abr 2016]. Disponible en: http://www.cdc.gov/safechild/pdf/National_Action_Plan_for_Child_Injury_Prevention.pdf
16. W. Haddon Jr. Advances in the epidemiology of injuries as a basis for public policy Public Health Rep., 95 (1980), pp. 411-421 Medline
17. W. Haddon Jr.,P. Valien,J.R. McCarroll,C.J. Umberger A controlled investigation of the characteristics of adult pedestrians fatally injured by motor vehicles in Manhattan J Chronic Dis., 14 (1961), pp. 655-678 Medline
18. A.R. Moritz,F.C. Henriques Studies of thermal injury II: the relative importance of time and surface temperature in the causation of cutaneous burns Am J Pathol., 23 (1947), pp. 695-720 Medline
19. Burns: Regenerative medicine and therapy,
20. R.E. Barrow,M.G. Jeschke,D.N. Herndon Early fluid resuscitation improves outcomes in severely burned children Resuscitation., 45 (2000), pp. 91-96 Medline
21. F. Jiménez,E.M. De Diego,F. Sandoval Quemaduras en la infancia. Valoración y tratamiento Bol Pediatr., 41 (2001), pp. 99-10
22. T. Lund,H. Onarheim,R.K. Reed Pathogenesis of edema formation in burn injuries World J Surg., 16 (1992), pp. 2-9 Medline
23. E.B. Wilson,J.G. McCormack Trauma and burns in children Anaest Intens Care Med., 13 (2012), pp. 31-36
24. C. Vivó,R. Galeiras,M.D. Del Caz Initial evaluation and management of the critical burn patient Med Intensiva., 40 (2016), pp. 49-59 http://dx.doi.org/10.1016/j.medin.2015.11.010 Medline
25. C. Porter,D.N. Herndon,L.S. Sidossis,E. Børsheim The impact of severe burns on skeletal muscle mitochondrial function Burns., 39 (2013), pp. 1039-1047 http://dx.doi.org/10.1016/j.burns.2013.03.018 Medline
26. B.S. Atiyeh,S.A. Dibo,A.E. Ibrahim,E.R. Zgheib Acute burn resuscitation and fluid creep: it is time for colloid rehabilitation Ann Burns Fire Disasters., 25 (2012), pp. 59-65 Medline
27. A.D. Rogers,J. Karpelowsky,A.J. Millar,A. Argent,H. Rode Fluid creep in major pediatric burns Eur J Pediatr Surg., 20 (2010), pp. 133-138 http://dx.doi.org/10.1055/s-0029-1237355 Medline
28. P. Hodgins,P. Hodgins,T. Potokar,P. Price Comparing rich and poor: Burn prevention in Wales, Pakistan, India, Botswana and Zambia Burns., 37 (2011), pp. 1354 1359 http://dx.doi.org/10.1016/j.burns.2011.07.001 Medline
29. D.N. Herndon,D. Gore,M. Cole,M.H. Desai,H. Linares,S. Abston Determinants of mortality in pediatric patients with greater than 70% full thickness total body surface area treated by early excision and grafting J Trauma., 27 (1987), pp. 208-212 Medline
30. T.T. Nguyen,D.A. Gilpin,N.A. Meyer,D.N. Herndon Current treatment of severely burned patients Ann Surg., 223 (1996), pp. 14-25 Medline
31. O.A. Olawoye,A.O. Iyun,S.A. Ademola,A.I. Michael,O.M. Oluwatosin Demographic characteristics and prognostic indicators of childhood burn in a developing country Burns., 40 (2014), pp. 1794-1798 http://dx.doi.org/10.1016/j.burns.2014.04.008 Medline
32. B.S. Atiyeh,M. Costagliola,S.N. Hayek Burn prevention mechanisms and outcomes: Pitfalls, failures and successes Burns., 35 (2009), pp. 181-193 http://dx.doi.org/10.1016/j.burns.2008.06.002 Medline
33. H. Sadeghi-Bazargani,R. Mohammadi,S. Amiri,N. Syedi,A. Tabrizi,P. Irandoost Individual-level predictors of inpatient childhood burn injuries: a case–control study BMC Public Health., 16 (2016), pp. 1-9 http://dx.doi.org/10.1186/s12889-015-2639-8 Medline
34. N. Alharthy,M. Al Mutairi,S. AlQueflie,A.B. Nefesa,N.B. Manie,S.B. Nafesa Pattern of burns identified in the Pediatrics Emergency Department at King Abdul-Aziz Medical City: Riyadh J Nat Sci Biol Med., 7 (2016), pp. 16-21 http://dx.doi.org/10.4103/0976-9668.175019 Medline
35. R. Spiwak,R. Lett,L. Rwanyuma,S. Logsetty Creation of a standardized burn course for Low Income Countries: Meeting local needs Burns., 40 (2014), pp. 1292-1299 http://dx.doi.org/10.1016/j.burns.2014.01.007 Medline
36. C. Mock,M. Peck,E. Krug,M. HaberalConfronting the global burden of burns: a WHO plan and a challenge Burns., 35 (2009), pp. 615-617 http://dx.doi.org/10.1016/j.burns.2008.08.016 Medline
37. S.N. Forjuoh Burns in low-and middle-income countries: a review of available literature on descriptive epidemiology, risk factors, treatment, and prevention Burns., 32 (2006), pp. 529-537 http://dx.doi.org/10.1016/j.burns.2006.04.002 Medline
38. F. Verey,M.D. Lyttle,Z. Lawson,R. Greenwood,A. Young When do children get burnt Burns., 40 (2014), pp. 1322-1328 http://dx.doi.org/10.1016/j.burns.2014.01.010 Medline
39. F. Cardona,A. Echeverri,J.F. Forero,C.A. García,C.M. Gómez,C.P. Gómez Epidemiología del trauma por quemaduras en la población atendida en un hospital infantil. Manizales 2004-2005 Rev Fac Med., 55 (2007), pp. 80-95
40. M.A. Hoyos,N.C. Jaramillo,M.E. Molina,S. Valverde,S. Ospina Epidemiological and clinical profile of burn victims Hospital Universitario San Vicente de Paúl, Medellín, 1994-2004 Burns., 32 (2006), pp. 1044-1051 http://dx.doi.org/10.1016/j.burns.2006.03.023 Medline
41. M.F. Sierra-Zúñiga,O.E. Castro-Delgado,J.C. Caicedo-Caicedo,Á.M. Merchán-Galvis,M. Delgado-Noguera Epidemiological profile of minor and moderate burn victims at the University Hospital San José, Popayán, Colombia, 2000-2010 Burns., 39 (2013), pp. 1012-1017 http://dx.doi.org/10.1016/j.burns.2012.11.007 Medline
42. K. Peleg,S. Goldman,F. Sikron Burn prevention programs for children: do they reduce burn-related hospitalizations Burns., 31 (2005), pp. 347 350 http://dx.doi.org/10.1016/j.burns.2004.10.028 Medline
43. S.R. Gimeniz-Paschoal,D.M. Pereira,N.E. Nascimiento Efect of an educative action on relatives’ knowledge about childhood burns at home Rev Lat Am Enfermagen., 17 (2009), pp. 341-346
44. T. Tse,C.H. Poon,K.H. Tse,T.K. Tsui,T. Ayyappan,A. Burd Pediatric burn prevention: An epidemiological approach Burns., 32 (2006), pp. 229-234 http://dx.doi.org/10.1016/j.burns.2005.08.025 Medline