LES SEQUELLES DE BRULURES CHEZ LENFANT : DONNEES EPIDEMIOLOGIQUES, CLINIQUES ET THERAPEUTIQUES. SEQUELAE OF BURNS IN CHILDREN: EPIDEMIOLOGICAL, CLINICAL AND THERAPEUTIC DATA

The sequelae of burns are defined as all the lesions that persist after six months of burn evolution. The purpose of this work is to report the different epidemiological aspects, etiological, clinical as well as the main therapeutic processes used in surgery of children with post-burn sequelae and emphasize the value of prevention. We retrospectively studied 143 patients who underwent surgery for post-burn sequelae and under 15 years. These patients are collected in the plastic surgery and burn department at Mohammed VI University Hospital in Marrakech for a period of 6 years from January 2012 to December 2017.The average age of patients was 6 years and 10 months. The sex ratio was 1,04. Two thirds of the population studied are of low socio-economic status. The causal agent was most often thermal, type boiling liquid (53,8%). The circumstances of the initial burn most frequently found were domestic accidents with a rate of 90,9% of all accidents, predominating in the summer period. Clinically, the sequelae were dominated by the contractures being 80,4%, associated in some cases to other types of sequelae which are: hypertrophic scarring, keloid, dyschromia and scar alopecia. These sequelae were located mainly at the upper limb (80,41%), the hand was the predominant site (39,8%). Over the 143 patients, 327 surgeries were performed in multiple operating times using different surgical techniques mainly: Z-plasty and derivations, skin graft, excisions-sutures and others taking into account the possibilities of rehabilitation. Results were rated satisfactory in 91% of our patients. Post-burn sequelae in children are frequent and serious, posing a major therapeutic problem, which gives an importance to the prevention.