Breast burns are not benign: Long-term outcomes of burns to the breast in pre-pubertal girls

Chest burns in pre-pubescent girl are commonly seen in paediatric burn units. These patients are at risk of significant long-term problems with scarring and breast development requiring reconstructive surgery many years after the initial burn. Admissions to our unit over a 20-year period were reviewed to determine the frequency of these burns. Patients whose burns required surgical debridement and split skin grafting, and who would now be post-pubertal were included in the study. We attempted to trace and contact these patients and were able to find 13 out of 22 patients, of whom 11 agreed to participate. The mechanism of injury in six was scalds and the other five had flame burns. Mean age of patients with scald was 18 months and for flame burns 4 years 8 months. These women required a variety of reconstructive procedures to improve breast appearance including contracture releases, dermabrasion, breast augmentation and contralateral breast reduction. Girls burned as young children require follow-up and appropriate referral long after the burn to ensure good cosmetic results are achieved during and after puberty.