Surgeons warn of lifelong consequences of severe burns - as new figures show there were over 35,000 child admissions in the past five years

• 49% (17,052) of child admissions to designated specialised burn services in the past five years involved scalds from hot food or drink.
• 51% (1,576) of child admissions for scalds to designated specialised burn services in 2018 involved children aged 0-2 years.
• 57% of the admissions to designated specialised burn services among 0-2 year-olds in 2018 related to hot tea or coffee spillages.
• The Royal College of Surgeons of England is backing this year’s “SafeTea Campaign” as part of National Burns Awareness Day.⁶


Plastic surgeons from the Royal College of Surgeons of England (RCS) and the British Burn Association are warning that children can face years of gruelling operations and treatment following preventable burns or scalds, such as from hot tea or coffee spillages. New figures from the International Burn Injury Database (iBID) show there were 35,007 child admissions to designated specialised burn services in England and Wales in the past five years (2014-2018).  

The figures show that almost half - 49% (17,052) - of child admissions to specialised burn NHS services, in the past five years, involved children who had been scalded by hot food or liquid spillages. 

As part of the ‘SafeTea Campaign’ to mark National Burns’ Awareness Day, surgeons are issuing preventative and first aid advice for burns. This year’s campaign aims to prevent serious scalds from mugs of hot tea or coffee and to reduce the number of children who are seriously burned each year, often due to preventable accidents.

A snapshot of the five year data, reveals that in 2018 there were 6,645 child admissions to designated specialised burn services in England and Wales; and 47% (3,119) of these burns to children involved spillages from hot food or drink.  Over half - 51% (1,576) - of these burns admissions for scalds involved children aged 0-2 years old.  More than half of these (57%) were for avoidable coffee and tea scalds.

The British Burn Association offers the following first aid advice for a burn: 

• Cool the burn with running cold tap water for 20 minutes and remove all clothing and jewellery (unless it is melted or firmly stuck to the wound).
• Call for help for any burn larger than a 50p coin: 999, 111 or your local GP for advice.
• Cover with cling film or a sterile, non-fluffy dressing or cloth. Make sure the patient is kept warm.

To prevent burns from happening in the home, the British Burn Association advises the public:
 
DO

✓Run COLD water first in the bath or sink before adding hot water - test the temperature.
✓Keep saucepans at the back of the stove NOT near the front - turn handles to the back. 
✓Keep hot drinks out of a child’s reach.

DON’T

X Drink hot drinks while nursing a baby or child.
X Put a baby or child into a bath or sink until the water has been tested.
X Warm baby bottles in microwaves.
X Leave children unattended in the kitchen.

Mr Andrew Williams, a consultant plastic surgeon at Chelsea and Westminster Hospital, who specialises in burns, says:  “Burn injuries are common and potentially devastating. Tragically they occur too often. Prevention is clearly key to reducing the number of patients we treat, which is why we want to raise awareness of this issue. All it takes is for a small child to pull a kettle cord, or knock a cup of tea over, and they can be scarred for life.  Every second counts when it comes to treating a new burn, so it is vital that parents know basic first aid - especially the importance of running scalded skin under cold water, for example.

He adds: “Recovering from a serious burn or scald can be physically gruelling if a patient has to undergo skin grafts and multiple operations, and it can impact the whole family. In young children, scar tissue might not grow with them, with the resulting need for potentially years of operations and therapy ahead of them.  The road to recovery can also be psychologically very challenging, especially if a person has visible scars.  This is why it is so important that we all – and particularly parents of young children – are aware of the simple steps they can take to reduce the likelihood of such accidents from happening the first place.”

The International Burn Injury Database is based on data from designated specialised burn services in England and Wales and therefore does not include minor injuries not referred to a burns service (i.e. where patients are treated by a GP surgery or in Accident and Emergency Departments).  

Mr Fadi Issa is a Consultant Plastic Surgeon at the Regional Burns Unit at Stoke Mandeville Hospital.  He is a previous RCS research fellow into burns reconstruction. Mr Issa says: “We see a large number of very young children with scald injuries where an accident has taken place at home.

“The way a burn is treated in those initial seconds and minutes after is crucial.  A recent study, which was carried out at Stoke Mandeville Hospital and the University of Oxford¹, and part-funded by the RCS, shows what a difference cooling a burn can make. Our advice is simple: 15-20-25. Run the scalded or burned skin under water at 15 °C for 20 minutes - and you could reduce the depth of a burn by up to 25%.² This treatment can convert a deep burn needing surgery to one that just needs simple dressings to heal. The other key information is not to put any lotions or potions on a cooled burn. Cover it in cling film and seek urgent medical assistance.”

Notes to editors

1. The study was carried out at Stoke Mandeville Hospital and the University of Oxford. It was funded partly by an RCS Fellowship awarded to Mr Hugh Wright, in association with the Restore Research Trust. The results have been published in the British Journal of Surgery (Wright et al. Human model of burn injury that quantifies the benefit of cooling as a first aid measure. BJS 2019, 106: 1472-1479).

2. https://preview.shorthand.com/NpjGkMEcbnkE3WpZ 

3. The Royal College of Surgeons of England (RCS) is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care. The Royal College of Surgeons is offering a one-year Research Fellowship in burns, wound healing or soft tissue reconstruction.

4. The British Burn Association is a charity for people interested in supporting and promoting burn care in the UK and Ireland. Its core aims are to educate and to encourage research into all aspects of burn injuries, including treatment and prevention.

5. The Children’s Burns Trust is a national charity dedicated to providing rehabilitation support for burned and scalded children and their families, as well as prevention and awareness campaigns. 

6. The Children’s Burns Trust works alongside the British Burn Association to raise awareness of National Burn Awareness Day each year. The aim is to highlight the main causes of burns and scalds and demonstrate that the majority of accidents are avoidable.  This year’s National Burn Awareness Day will raise awareness of the ‘SafeTea Campaign’ which aims to prevent serious scalds from mugs of hot tea or coffee, and to ensure that parents and carers know how to give burns first aid.  See   www.SafeTea.org.uk for more information. 

7. In 2004, the UK National Burn Care Group (NBCG) funded the creation of the UK National Burn Injury Database (UK.NBID), which included the creation of the International Burn Injury Database (iBID) data collection system and the infrastructure to support it. In April 2005, the data collection and analysis began. The design of the International Burn Injury Database  (iBID) software was based on recording what happens clinically following burn injury and to extract from that service management information that can be used for advances in burns management.

8. There are 23 designated specialised burn services in England and Wales. Specialised burn services focus on the management of people with burns which require referral to and assessment by, a specialised burn service (in line with agreed National Referral Guidance). 

9. In England and Wales burn care is organised using a tiered model of care whereby the most severely injured are cared for in services recognised as Centres and those requiring less intensive clinical support being cared for in either a Unit or a Facility. This provides a balance between easy access and care provided closer to home for the majority of patients with highly specialised, centralised services for a much smaller proportion of patients with more severe injuries: https://www.england.nhs.uk/wp-content/uploads/2014/04/d06-spec-burn-care-0414.pdf

10. The study described in Mr Issa’s comments is published in the British Journal of Surgery (Wright et al. Human model of burn injury that quantifies the benefit of cooling as a first aid measure. BJS 2019, 106: 1472-1479).  

11. For more information, or to arrange an interview with Mr Williams or Mr Issa, please contact the RCS Press Office: 
• Telephone: 020 7869 6047/6052 
• Email: pressoffice@rcseng.ac.uk 
• Out of hours media enquiries: 07966 486832