Pediatric Treadmill Friction Burns to the Hand: Outcomes of an Initial Nonoperative Approach.

Treadmill burns that occur from friction mechanism are a common cause of hand burns in children. These burns are deeper and more likely to require surgical intervention compared to hand burns from other mechanisms. The purpose of this study is to identify the factors associated with healing time using an initial non-operative approach. A retrospective chart review was performed examining children (<15 years) who were treated for treadmill burns to the hand between 2012 and 2019. Patient age, burn depth, total body surface area of the hand injury, and time-to-healing were recorded. Topical wound management strategies (silver sheet, silver cream, non-silver sheet, non-silver cream) and associated treatment durations were determined. For patients with burns to bilateral hands, the features, treatment, and outcomes of each hand were assessed separately. Cox regression analysis was used to evaluate the association between time-to-healing and patient characteristics and treatment type. Seventy-seven patients with 86 hand burns (median age 3 years, range 1-11) had a median total body surface area per hand burn of 0.8% (range 0.1%-1.5%). Full thickness burns (n=47, 54.7%) were associated with longer time-to-healing compared to partial thickness burns (HR 0.28, CI 0.15, 0.54, p<.001). Silver sheet treatment was also associated with more rapid time-to-healing compared to treatment with a silver cream (HR 2.64, CI 1.01, 6.89, p=.047). Pediatric treadmill hand burns can be managed successfully with a non-operative approach. More research is needed to confirm the superiority of treatment with silver sheets compared to treatment with silver creams. Copyright (c) The Author(s) 2020. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: [email protected].

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