Sofia has three sisters, one of them just a few months old, so her parents really have their hands full. During a hectic moment the four-year-old reached for a lighter when no one was watching, and shortly after her shirt caught fire. Despite a lightning fast reaction by the family, Sofia suffered burns in the chest area. A tragic isolated incident? Absolutely not. Burns and scalds are the second most frequent cause of accidents in infants – and almost all of them occur in the household. That Sofia’s clothing caught fire so quickly would hardly have surprised the experts at the German consumer advocacy organization Stiftung Warentest. They investigated in 2009 whether or not children's clothing offered protection against flames. The result: unfortunately not – all 44 test samples burned. For 40 of those clothing items the fire hazard was high, or even very high. Light textiles made from cotton, in particular, burnt particularly quickly. Besides open fires, there are many other dangers lurking in the kitchen, bathroom and living room – from the range, clothes iron right through to hot meals and beverages. The content of a single cup is enough to scald almost one third of the body surface of a baby or infant.
This four-year-old girl is being looked after by the medical supply store Schad in Aalen (Germany). Four master craftsman and 22 qualified staff advise and support their customers, who come from all around the East Alb district. Sofia wears a Juzo Expert thorax segment that was custom-made according to her measurements. The girl particularly likes the Juzo iron-on transfers that she wears on the left and right sleeve. Butterflies flutter on the green bandage, and kittens purr on the pink one. The iron-on transfers are a great motivation for constantly wearing the bandage, and help ensure a successful outcome for the scar therapy.
The Robert Koch Institute estimates that about 2.8 million accidents happen in Germany alone. Seven times more people are involved in an accident within their own four walls than on the roads (0.39 million). It is therefore comforting to know that when worst comes to worst, medical help is available around the clock and there exists an extensive network of hospitals that can provide the necessary medical care.
In In Afghanistan, the country from which little Samiullah comes, the situation is totally different. Household accidents happen there too, but access to medical assistance is a matter of luck. There are only two physicians and 4.2 hospital beds per 10,000 population. 80 percent of the physicians work in the capital city of Kabul. 60 percent of the hospital beds and 40 percent of the drugstores are concentrated there too. Samiullah comes from an outlying province, however. The rural population has far less access to medical care – and special cases like burn injuries often don’t get treated at all.
Because the eight-year-old was unable to be taken care of in his home country, the Friedensdorf society organized treatment for him in Germany. This society in Oberhausen has been providing medical assistance to sick and injured children in war or crisis zones on a case-by-case basis since 1967. “Our greatest goal would be for our work to no longer be required because there are no more wars”, says Ronald Gegenfurtner of the Friedensdorf society, knowing full well that this goal has been pushed out yet again into the distant future. In outpatient clinics in the relevant countries, children are selected that are given the opportunity to fly back to Germany. Often their lives are hanging by a thread. Unfortunately there are usually less treatment places available than children in need of help. Nevertheless more than 1,000 injured or sick children are able to receive medical treatment each year thanks to the society. After their treatment in hospital, the children come to Friedensdorf for rehabilitation. The children’s wounds are cared for, they learn to walk or grip using their prosthesis, and they learn to manage their medications. And they learn to play freely and without fear. They heal in body and mind.
The 3-year old Emre Demir spilt coffee on himself thereby suffering Grade IIb and III burns. Grade II burns are accompanied by blister formation and strong pain. The epidermis and dermis are affected, and for Grade IIb burns, scar formation and deep damage to the dermis occurs as well. Grade III burns are characterized by black/white necroses and the destruction of nerve endings. The dermis and subcutis are affected; the damage is irreversible. The affected area on little Emre’s elbow amounted to 4 % of his body surface.
Due to the depth of the injury, the affected area was repaired using a split-thickness graft. While changing his dressings, small pieces of the transplanted material detached and could not be saved. At the last dressing change 12 days after the transplantation, measurements were taken for a compression sleeve. 14 days later the garment was tried on and dispensed. Two months later a new compression sleeve was ordered because the child had grown. As there were regions of marked hypertrophic changes in the scar surface, an impression for a silicone pad was also taken at this time. This was dispensed 14 days later.
Three months later, a scheduled follow-up appointment was held in the clinic. The result: The scar was still active and slightly reddened, but the scar was significantly softer and flatter in appearance. Thanks to the good treatment he received, little Emre Demir shows no restriction in movement in the elbow area. Given the good results obtained, the treatment with the compression sleeve and silicone pad will be continued and regular reviews conducted in the burn clinic every three months.