Campfire Burns of the Palms in Crawling Infants in Saudi Arabia: Results Following Release and Graft of Contractures

In Saudi Arabia, camping in the desert is commonly practiced by families. A campfire is usually lit and unsupervised crawling infants are at risk of burns from these campfires. During a 12-year period, a total of 53 children with hand contractures related to campfire burns were treated. The mean age at the time of burn was 9 months (range: 5-12 months). All patients presented with isolated palmar contractures; of one (n = 24) or both (n = 29) hands. Surgical release and skin grafting were performed for a total of 82 hands. Full-thickness skin grafts from the groin area were used in mild cases, and thick split-thickness skin grafts harvested from the thigh were used in severe contractures. Graft take ranged from 90 to 100% "take" in all patients. Follow-up ranged from 6 months to 10 years. Recurrence of contracture was calculated for 30 children (52 grafted hands) who had follow-up for more than 5 years. Twenty hands (group 1) had thick split-thickness skin grafts, and 10 (50%) of these required a second release and grafting procedure. The remaining 32 hands (group 11) had full-thickness grafts and only 3 (9.4%) required a second release and grafting procedure. The difference was statistically significant (P = .003), indicating that group I are more likely to require secondary surgery on long-term follow-up. (J Burn Care Res 2009;30:616-619)