Growth delay in postburn pediatric patients
R. L. Rutan and D. N. Herndon
Shriners Burns Institute, Galveston, TX 77550.
Dampened height and weight velocities have been observed in our postburn
pediatric population. To validate this phenomenon, the medical records of
80 patients who had sustained a greater than 40% total body surface area
burn, were older than 2 years of age at the time of the burn, and were at
least 1 year post burn were reviewed. All patients were treated with early
excision of the burn wound within 72 hours of injury and received standard
post burn resuscitational and nutritional support. Admission height and
weight plots were within normal distribution parameters. Yearly growth
velocities were calculated for up to 3 years after the burn. Despite
adequate nutritional support and maximal exercise and/or long-bone
stresses, a profound growth arrest was noted during postburn year 1, which
slowly resolved to near normal distribution by postburn year 3. This
retrospective study demonstrates that severe thermal injury is associated
with a growth delay in the pediatric population. The exact cause of this
phenomenon remains unknown.