PubMed · 5171024
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A R Holder. 1971-10-25. Prostatectomies.. https://doi.org/10.1001/jama.218.4.651
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Two groups of children who had sustained electrical burns to the oral commissure were compared. The first group (n = 20) underwent splinting of the commissure and the other group (n = 22) did not have splints as part of their treatment regimen. The mean age at the time of burn was 3 years in both groups. The need for commissuroplasty was significantly decreased in the splinted group (P = 0.0007 by Fisher's exact test). Further analysis of the duration of splinting in the splinted group (n = 20) revealed that all seven children who required commissuroplasty underwent splinting for less than 4 months while all 13 children who did not require surgery used their splints for more than 4 months (range 4-8 months).
Electrical burns of the mouth are relatively common in young children. Early intervention to prevent complications remains controversial. A chart review was conducted of 24 patients with oral commissure burns who were treated at the University of Iowa from 1975 to 1988. All of these patients were treated conservatively without splinting or early surgery. Only one patient underwent oral splinting before receiving care at the University of Iowa Hospitals and Clinics. While under our care, no patients suffered significant hemorrhage at eschar separation. Commissuroplasty and/or reconstructive lip surgery were performed at various times after the burn injury was healed and the functional or aesthetic impairment was established. Long-term follow-up was from 5 to 17 years, allowing for longitudinal evaluation of the postburn scars and their influence on facial growth. Our review revealed that (1) younger children with more severe burns have a less favorable outcome; (2) no hemorrhage was observed immediately after the burn or at eschar separation; and (3) conservative surgical treatment after scar maturation- and in some cases following steroid injections- resulted in a successful functional and esthetic outcome.
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