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Klin Padiatr 2018; 230(02): 61-67
DOI: 10.1055/s-0043-119416
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Dunkelziffer nicht-akzidenteller thermischer Verletzungen im Kindesalter – Kinderschutzstrategien zur Reduktion

Undetected Cases of Non-Accidental Burns in Children – Preventive Strategies
Michaela Klinke
1   Department of Pediatric Surgery, University Hospital Hamburg Eppendorf, Hamburg
,
Claudia Maria Schmidt
2   Department of Child Protection, Altonaer Kinderkrankenhaus gGmbH, Hamburg
,
Laura Tegtmeyer
3   Department of Pediatrics, Division of Neonatology and Pediatric Intensive Care, Universitatsklinikum Hamburg-Eppendorf, Hamburg
,
Konrad Reinshagen
1   Department of Pediatric Surgery, University Hospital Hamburg Eppendorf, Hamburg
,
Michael Boettcher
1   Department of Pediatric Surgery, University Hospital Hamburg Eppendorf, Hamburg
,
Ingo Koenigs
1   Department of Pediatric Surgery, University Hospital Hamburg Eppendorf, Hamburg
4   Department of Pediatric Surgery, Burn Unit, Plastic and Reconstructive Surgery, Altonaer Kinderkrankenhaus gGmbH, Hamburg
› Author Affiliations
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Publication History

Publication Date:
19 December 2017 (online)

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Zusammenfassung

Hintergrund Thermische Verletzungen stellen eine relevante Unfallursache im Kindesalter dar und sind häufig mit langen Krankenhausaufenthalten und schwerwiegenden physischen und psychischen Beeinträchtigungen der Patienten sowie oftmals lebenslangen Folgen verbunden. Verbrühungen, insbesondere im Kleinkindalter, sind die häufigste Form thermischer Verletzungen. Neben akzidentellen Unfallhergängen spielen nicht-akzidentelle Verletzungen eine wesentliche Rolle. Diese von akzidentellen Verletzungen zu unterscheiden, ist von höchster Wichtigkeit und stellt eine enorme Herausforderung für Ärzte, Pflegende und Mitarbeiter psychosozialer Dienste dar.

Methode In dieser multizentrischen Registerstudie wurden thermische Kindeswohlgefährdungen in Deutschland über einen Zeitraum von 10 Jahren analysiert.

Ergebnisse Es wurden Daten von 13.353 pädiatrischen Patienten mit thermischen Verletzungen aus 32 Krankenhäusern der Jahre 2006 bis 2015 in Deutschland erhoben. Entsprechend den Ergebnissen dieser Studie erscheint die Anzahl nicht-akzidenteller thermischer Verletzungen mit 0,5% in Deutschland im Vergleich zu internationalen Erhebungen, die von durchschnittlich 10% berichten, deutlich unterrepräsentiert.

Diskussion Es ist naheliegend, dass sich hinter dieser Differenz eine nicht unerhebliche Dunkelziffer verbirgt und wir folglich in Deutschland einen relevanten Anteil nicht-akzidenteller thermischer Verletzungen übersehen. Ziel dieser Arbeit ist die Vermittlung eines Bewusstseins und die Sensibilisierung für nicht-akzidentelle thermische Verletzungen im Kindesalter. Darüber hinaus wird eine Strategie zur Erhöhung der Detektionsrate und Reduktion der Dunkelziffer definiert.

Schlussfolgerung Zukünftig ist eine umfassendere Datenerhebung notwendig, um nicht-akzidentelle thermische Verletzungen im Kindesalter realitätsnah abzubilden. Dies wird mit dem neu konzeptionierten Verbrennungsregister der Deutschen Gesellschaft für Verbrennungsmedizin (DGV) und des Arbeitskreises „Das schwerbrandverletzte Kind“ umgesetzt.

Abstract

Background Thermal injuries are a frequent cause of accidents within the pediatric population that may result in long periods of hospitalization as well as severe physical and mental impairment and lifelong consequences. Especially in infants, burns caused by scalding are the most common cause of injury. Beside accidental injuries, intential burns may also occur. It is of utmost importance to differentiate between intentional and accidental burns, yet the distinction can be very demanding for physicians, nurses and social workers.

Methods In this retrospective multicenter study, thermally inflicted burns in Germany were analyzed over a period of 10 years.

Results Data of 13.353 pediatric patients with thermal injuries from 32 hospitals were analyzed within the period of 2006 to 2015. The study results show that 0,5% of all burns were inflicted. This percentage seems to be an inadequate represention as compared to reported international surveys, which report an average of 10% of all burns being inflicted in pediatric patients.

Discussion When comparing our results to international survey results, it can be assumed that a large number of child abuse cases go undetected within the German pediatric population. In particular awareness of intentional burns needs to be raised and detection strategies, as presented in this paper, implemented.

Conclusion In the future, a more precise collection of data of burned children is necessary to illustrate the true number of intentional pediatric burns in Germany. This has been implemented by the renewed pediatric burn registry of the German Society for Burn Treatment (DGV) and the working group “The severely burned child”.

Schlüsselwörter

Thermische Verletzungen im Kindesalter - nicht-akzidentelle thermische Verletzungen - Kindesmisshandlung - Kindeswohlgefährdung - Deutschland - Register

Key words

Pediatric burns - intentional burns - inflicted burns - child abuse - Germany - registry
 

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