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Exercise Caution: Treadmills Burn More Than Calories
Audrey A. Kesselring, MD, Kevin P. Yakuboff, MD, Donna M. Mertens, RN, BSN and Carol A. Schwanholt, OTR/L
University of Cincinnati Division of Plastic, Reconstructive and Hand Surgery
2012-02-02
Presenter: Audrey Kesselring
Affidavit:
The resident compiled the data into an abstract and paper with the guidance of her attending, who performed the surgeries and helped identify the patients who may quality for the study.
Director Name: William John Kitzmiller
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: Hand
How does this presentation meet the established conference educational objectives?
This paper provides an analysis of the current concepts in burn reconstruction with regards to a specific injury pattern that is seen with relative frequency, treadmill burns in children. It is important to recognize the frequency of this pattern and, ideally, to put programs in place to increase prevention. Also important is for the plastic surgery community to recognize when conservative management results in improved outcomes as compared to surgical intervention. In this series, we present the largest review of such an injury pattern and suggestions for treatment that provide the best long-term outcomes.
How will your presentation be used by practicing physicians in the audience?
Pediatric burn injuries are a common reason for plastic surgery consultation both at academic institutions and in the community. Plastic surgeons maintain a unique ability to care for a large variety of patients and patient problems. This particular paper hightlights the continued need to evaluate our treatment algorithms and to challenge the status quo.
We present the largest series to date of treadmill injuries in children. This injury pattern not only continues to be a serious and preventable problem, but is actually on the rise as the popularity of in-home exercise equipment grows. The aim of this paper was to review our experience with these types of injuries at Shriners Hospital for Children Cincinnati and to evaluate outcomes based on treatment plans. We conducted a retrospective review of 55 children who sustained burn injuries on treadmills over an eight year period. Males held the slight majority and average age at injury was 3.6 + 2.5 years (mean + SEM). Most burns in this series were limited to the upper extremity and a 77% of cases were treated non-operatively with equally good functional results compared to patients who had acute surgical intervention. On the contrary, late presenting injuries are more likely to require an operation for improved functional outcome. While the injury pattern is most commonly not life-threatening, the resulting functional disabilities can be life-altering. Our review suggests treatment protocols should favor conservative, non-operative management when treatment is initiated in the acute setting including aggressive rehabilitation with focus on scar management to prevent functionally significant contracture.
