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Results

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.

 

Overall results: population data from included studies

 

Intentional and unintentional scalds

  • Study designs:
    2 case-control 12,16
    10 cross-sectional 1,5,8,13,15,19,21,25,32,33
    21 case study / case series 2-4,6,7,9-11,14,17,18,20,22-24,26-31
  • In 26/30 applicable studies including abuse cases, the ranking of abuse was 1 or 2 1-5,7-12,14,16,17,20-27,29,31-33
  • Age: ranging from 0-18 years
  • Gender:
    • There was no apparent difference in the frequency between boys and girls between abusive and unintentional scalds 
      • Significantly more boys sustained abusive scalds 15,31
      • One study showed that boys sustained more unintentional non-tap water scalds than girls (61.5% boys to 38.5% girls (total 104 children)) 19
  • No study addressed the diagnosis of intentional scalds in disabled children

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References

  1. Ayoub C, Pfeifer D. Burns as a manifestation of child abuse and neglect. American Journal of Diseases in Children. 1979;133(9):910-914 [Pubmed]
  2. Bajanowski T, Verhoff MA, Wingenfeld L, Püschel K. Forensische Pädopathologie – Tod nach Verbrühung. Drei Fälle mit sehr unterschiedlichen Kausalbedingungen [German] [Forensic paedopathology – death by scalding. Three cases with very different causal conditions]. Rechtsmedizin. 2007;17(4):218-222 [Abstract from SpringerLink]
  3. Brinkmann B, Banaschak S. Verbrühungen bei einem Kleinkind: Unfall oder Kindesmißhandlung? Monatsschrift für Kinderheilkunde. 1998;146(12):1186-1191 [Abstract from SpringerLink]
  4. Caniano DA, Beaver BL, Boles ET. Child abuse. An update on surgical management in 256 cases. Annals of Surgery. 1986;203(2):219-224 [Pubmed]
  5. Daria S, Sugar NF, Feldman KW, Boos SC, Benton SA, Ornstein A. Into hot water head first: distribution of intentional and unintentional immersion burns. Pediatric Emergency Care. 2004;20(5):302-310 [Pubmed]
  6. Deitch EA, Staats M. Child abuse through burning. Journal of Burn Care & Research. 1982;3(2):89-94 [Abstract from Journal of Burn Care & Research]
  7. Dressler DP, Hozid JL. Thermal injury and child abuse: the medical evidence dilemma. Journal of Burn Care & Rehabilitation. 2001;22(2):180-185 [Pubmed]
  8. Durtschi MB, Kohler TR, Finley A, Heimbach DM. Burn injury in infants and young children. Surgery, Gynecology & Obstetrics. 1980;150(5):651-656 [Pubmed]
  9. Galleno H, Oppenheim WL. The battered child syndrome revisited. Clinical Orthopaedics and Related Research. 1982;162:11-19 [Pubmed]
  10. Grosfeld JL, Ballantine TVN. Surgical aspects of child abuse (trauma-X). Pediatric Annals. 1976;5(10):106-120 [Pubmed citation only]
  11. Hashimoto I, Nakanishi H, Nagae H, Yamano M, Takeuchi N, Nameda Y, Arase S, Nii M, Taguchi Y, Kuroda Y. Child abuse-related burns: Two cases of severe burns related to child abuse syndrome. Japanese Journal of Plastic and Reconstructive Surgery. 1995;38:149-154
  12. Hayek SN, Wibbenmeyer LA, Kealey LDH, Williams IM, Oral R, Onwuameze O, Light TD, Latenser BA, Lewis RW 2nd, Kealey GP. The efficacy of hair and urine toxicology screening on the detection of child abuse by burning. Journal of Burn Care and Research. 2009;30(4):587-592 [Pubmed]
  13. Heaton PA. The pattern of burn injuries in childhood. New Zealand Medical Journal. 1989;102(879):584-586 [Pubmed]
  14. Heredea LS. Diagnostic problems of burns produced by physical abuse towards children. Archives of the Balkan Medical Union. 2008;43(3):171-176 [Abstract from Archives of the Balkan Medical Union]
  15. Hicks RA, Stolfi A. Skeletal surveys in children with burns caused by child abuse. Pediatric Emergency Care. 2007;23(5):308-313 [Pubmed]
  16. Hobbs CJ. When are burns not accidental? Archives of Disease in Childhood. 1986;61(4):357-361 [Pubmed]
  17. Holter JC, Friedman SB. Etiology and management of severely burned children. American Journal of Diseases in Children. 1969;118(5):680-686 [Pubmed citation only]
  18. Leonardi DF, Vedovato JW, Werlang PM, Torres OM. Child burn: accident, neglect or abuse. A case report. Burns. 1999;25(1):69-71 [Pubmed]
  19. Lowell G, Quinlan K, Gottlieb LJ. Preventing unintentional scald burns: moving beyond tap water. Pediatrics. 2008;122(4):799-804 [Pubmed]
  20. Lung RJ, Miller SH, Davis TS, Graham WPI. Recognizing burn injuries as child abuse. American Family Physician. 1977;15(4):134-135 [Pubmed citation only]
  21. Ofodile F, Norris J, Garnes A. Burns and child abuse. The East African Medical Journal. 1979;56(1):26-29 [Pubmed citation only]
  22. Ojo P, Palmer J, Garvey R, Atweh N, Fidler P. Pattern of burns in child abuse. American Surgeon. 2007;73(3):253-255 [Pubmed]
  23. Patscheider H. Zwei ungewöhnliche Fälle von tödlicher Kindesmißhandlung [German] [Two unusual cases of fatal child abuse]. Archiv für Kriminologie.1975;155(1):19-27 [Pubmed citation only]
  24. Phillips PS, Pickrell E, Morse TS. Intentional burning: a severe form of child abuse. Journal of the American College of Emergency Physicians. 1974;3(6):388-390 [Abstract from ScienceDirect]
  25. Purdue GF, Hunt JL, Prescott PR. Child abuse by burning — an index of suspicion. The Journal of Trauma. 1988;28(2):221-224 [Pubmed]
  26. Russo S, Taff ML, Mirchandani HG, Monforte JR, Spitz WU. Scald burns complicated by isopropyl alcohol intoxication: a case of fatal child abuse. The American Journal of Forensic Medicine and Pathology. 1986;7(1):81-83 [Pubmed]
  27. Schlievert R. Child abuse or mimic? Is there a medical explanation? Consultant. 2004;44:1160-1161
  28. Sheridan RL. Recognition and management of hot liquid aspiration in children. Annals of Emergency Medicine. 1996;27(1):89-91 [Pubmed]
  29. Stratman E, Melski J. Scald abuse. Archives of Dermatology. 2002;138(3):318-320 [Pubmed citation only]
  30. Titus MO, Baxter AL, Starling SP. Accidental scald burns in sinks. Pediatrics. 2003;111(2):e191-e194 [Pubmed]
  31. Wibbenmeyer L, Liao J, Heard J, Kealey L, Kealey G, Oral R. Factors related to child maltreatment in children presenting with burn injuries. Journal of Burn Care & Research. 2014;35(5):374-381 [Pubmed]

  32. Yeoh C, Nixon JW, Dickson W, Kemp A, Sibert JR. Patterns of scald injuries. Archives of Disease in Childhood. 1994;71(2):156-158 [Pubmed]
  33. Zaloga WF, Collins KA. Pediatric homicides related to burn injury: a retrospective review at the Medical University of South Carolina. Journal of Forensic Sciences. 2006;51(2):396-399 [Pubmed]

Influence of ethnicity and socio-economic group

 

  • None of the included studies addressed this issue

Details of comparative studies

 

  • Study designs:
    2 case-control 5,6
    4 cross sectional 1,3,7,9
    3 case series 2,4,8
  • Age: ranging from 0-18 years

Click here to open

References

  1. Ayoub C, Pfeifer D. Burns as a manifestation of child abuse and neglect. American Journal of Diseases in Children. 1979;133(9):910-914 [Pubmed]
  2. Bajanowski T, Verhoff MA, Wingenfeld L, Püschel K. Forensische Pädopathologie – Tod nach Verbrühung. Drei Fälle mit sehr unterschiedlichen Kausalbedingungen [German] [Forensic paedopathology – death by scalding. Three cases with very different causal conditions]. Rechtsmedizin. 2007;17(4):218-222 [Abstract from SpringerLink]
  3. Daria S, Sugar NF, Feldman KW, Boos SC, Benton SA, Ornstein A. Into hot water head first: distribution of intentional and unintentional immersion burns. Pediatric Emergency Care. 2004;20(5):302-310 [Pubmed]
  4. Dressler DP, Hozid JL. Thermal injury and child abuse: the medical evidence dilemma. Journal of Burn Care & Rehabilitation. 2001;22(2):180-185 [Pubmed]
  5. Hayek SN, Wibbenmeyer LA, Kealey LDH, Williams IM, Oral R, Onwuameze O, Light TD, Latenser BA, Lewis RW 2nd, Kealey GP. The efficacy of hair and urine toxicology screening on the detection of child abuse by burning. Journal of Burn Care and Research. 2009;30(4):587-592 [Pubmed]
  6. Hobbs CJ. When are burns not accidental? Archives of Disease in Childhood. 1986;61(4):357-361 [Pubmed]
  7. Lowell G, Quinlan K, Gottlieb LJ. Preventing unintentional scald burns: moving beyond tap water. Pediatrics. 2008;122(4):799-804 [Pubmed]
  8. Ojo P, Palmer J, Garvey R, Atweh N, Fidler P. Pattern of burns in child abuse. American Surgeon. 2007;73(3):253-255 [Pubmed]
  9. Yeoh C, Nixon JW, Dickson W, Kemp A, Sibert JR. Patterns of scald injuries. Archives of Disease in Childhood. 1994;71(2):156-158 [Pubmed]

Details of non-comparative studies

 

  • 23 included studies addressed either unintentional or intentional scalds Intentional non-comparative studies 1-21 Unintentional non-comparative studies 1,2
  • Study designs:
    6 cross sectional Intentional non-comparative studies 4,8,10,14,17,21
    17 case study / case series Intentional non-comparative studies 1-3,5-7,9,11-13,15,16,18-20 Unintentional non-comparative studies 1,2
  • In 17/21 applicable studies ranking of abuse was 1 or 2 Intentional non-comparative studies 1,2,4-7,9,11,13-21
  • Age: ranging from 0-18 years

 

Click here to open

References

Intentional non-comparative studies

  1. Brinkmann B, Banaschak S. Verbrühungen bei einem Kleinkind: Unfall oder Kindesmißhandlung? Monatsschrift für Kinderheilkunde. 1998;146(12):1186-1191 [Abstract from SpringerLink]
  2. Caniano DA, Beaver BL, Boles ET. Child abuse. An update on surgical management in 256 cases. Annals of Surgery. 1986;203(2):219-224 [Pubmed]
  3. Deitch EA, Staats M. Child abuse through burning. Journal of Burn Care & Research. 1982;3(2):89-94 [Abstract from Journal of Burn Care & Research]
  4. Durtschi MB, Kohler TR, Finley A, Heimbach DM. Burn injury in infants and young children. Surgery, Gynecology & Obstetrics. 1980;150(5):651-656 [Pubmed]
  5. Galleno H, Oppenheim WL. The battered child syndrome revisited. Clinical Orthopaedics and Related Research. 1982;162:11-19 [Pubmed]
  6. Grosfeld JL, Ballantine TVN. Surgical aspects of child abuse (trauma-X). Pediatric Annals. 1976;5(10):106-120 [Pubmed citation only]
  7. Hashimoto I, Nakanishi H, Nagae H, Yamano M, Takeuchi N, Nameda Y, Arase S, Nii M, Taguchi Y, Kuroda Y. Child abuse-related burns: Two cases of severe burns related to child abuse syndrome. Japanese Journal of Plastic and Reconstructive Surgery. 1995;38:149-154
  8. Heaton PA. The pattern of burn injuries in childhood. New Zealand Medical Journal. 1989;102(879):584-586 [Pubmed]
  9. Heredea LS. Diagnostic problems of burns produced by physical abuse towards children. Archives of the Balkan Medical Union. 2008;43(3):171-176 [Abstract from Archives of the Balkan Medical Union]
  10. Hicks RA, Stolfi A. Skeletal surveys in children with burns caused by child abuse. Pediatric Emergency Care. 2007;23(5):308-313 [Pubmed]
  11. Holter JC, Friedman SB. Etiology and management of severely burned children. American Journal of Diseases in Children. 1969;118(5):680-686 [Pubmed citation only]
  12. Leonardi DF, Vedovato JW, Werlang PM, Torres OM. Child burn: accident, neglect or abuse. A case report. Burns. 1999;25(1):69-71 [Pubmed]
  13. Lung RJ, Miller SH, Davis TS, Graham WPI. Recognizing burn injuries as child abuse. American Family Physician. 1977;15(4):134-135 [Pubmed citation only]
  14. Ofodile F, Norris J, Garnes A. Burns and child abuse. The East African Medical Journal. 1979;56(1):26-29 [Pubmed citation only]
  15. Patscheider H. Zwei ungewöhnliche Fälle von tödlicher Kindesmißhandlung [German] [Two unusual cases of fatal child abuse]. Archiv für Kriminologie.1975;155(1):19-27 [Pubmed citation only]
  16. Phillips PS, Pickrell E, Morse TS. Intentional burning: a severe form of child abuse. Journal of the American College of Emergency Physicians. 1974;3(6):388-390 [Abstract from ScienceDirect]
  17. Purdue GF, Hunt JL, Prescott PR. Child abuse by burning — an index of suspicion. The Journal of Trauma. 1988;28(2):221-224 [Pubmed]
  18. Russo S, Taff ML, Mirchandani HG, Monforte JR, Spitz WU. Scald burns complicated by isopropyl alcohol intoxication: a case of fatal child abuse. The American Journal of Forensic Medicine and Pathology. 1986;7(1):81-83 [Pubmed]
  19. Schlievert R. Child abuse or mimic? Is there a medical explanation? Consultant. 2004;44:1160-1161
  20. Stratman E, Melski J. Scald abuse. Archives of Dermatology. 2002;138(3):318-320 [Pubmed citation only]
  21. Zaloga WF, Collins KA. Pediatric homicides related to burn injury: a retrospective review at the Medical University of South Carolina. Journal of Forensic Sciences. 2006;51(2):396-399 [Pubmed]

Unintentional non-comparative studies

  1. Sheridan RL. Recognition and management of hot liquid aspiration in children. Annals of Emergency Medicine. 1996;27(1):89-91 [Pubmed]
  2. Titus MO, Baxter AL, Starling SP. Accidental scald burns in sinks. Pediatrics. 2003;111(2):e191-e194 [Pubmed]

 

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