Surgical management of extrahepatic portal vein obstruction in children: advantages of MesoRex shunt compared with distal splenorenal shunt.

Purpose: To review surgical management of extrahepatic portal vein obstruction (EHPVO) at Red Cross War Memorial Children's Hospital and compare MesoRex shunt (MRS) with distal splenorenal shunt (DSRS).

Methods: This is a single-centre retrospective review documenting pre- and post-operative data in 21 children. Twenty-two shunts were performed, 15 MRS and 7 DSRS, over an 18-year period.

Cross-cultural validation of the Itch Man Scale in pediatric burn survivors in a South African setting.

Introduction: Pruritus or itch is a common symptom after burn injuries. The Itch Man Scale has been recommended to assess itch severity in children. The aim of this prospective observational study was to perform a cross-cultural validation of the Itch Man Scale by comparing it with the Numeric Rating Scale (NRS) and the Toronto Pediatric Itch Scale.

The Effect of Electrical Load Shedding on Pediatric Hospital Admissions in South Africa.

Background: South Africa faced repeated episodes of temporary power shutdowns, or load shedding, in 2014/2015. The effect of load shedding on children's health is unknown.

Methods: We determined periods of load shedding using Twitter, Facebook, and data from the City of Cape Town.

Acceptability and functionality of the "Kettle Strap": An attempt to decrease kettle related burns in children.

Background: Extensive hot water burns (HWB) are common at Red Cross War Memorial Children's Hospital (RCWMCH). The majority are caused by kettle scalds. These burn injuries usually affect toddlers living in poor socio-economic circumstances.

The history of the formation of the Pan African paediatric surgical Association (PAPSA).

Political change in the 1990s in Southern Africa influenced the long awaited formation of a children's surgical association in Africa. Here, within is the historical account of the formation of the Pan African Association of Paediatric Surgeons (PAPSA). The basis of the argument for the formation of PAPSA was that paediatric surgeons from Africa have a wealth of experience and special knowledge of diseases affecting children in the African continent which differ substantially from those encountered in other regions of the world.

Post burn pruritus in pediatric burn patients.

Background: Pruritus is a common problem seen in the healing process of a burn wound and gives great discomfort for the patient. Most research in this field has been done in the adult population, so evidence in the pediatric population is still lacking PURPOSE: The aims of this study were to assess the incidence and severity of post-burn pruritus, identify predictors for pruritus and evaluate the pharmacological treatments in a pediatric setting.

Methods: Pruritus was assessed in this prospective observational study using a numeric rating scale and the Itch Man Scale applied by the patients' caregiver.

Can live music therapy reduce distress and pain in children with burns after wound care procedures? A randomized controlled trial.

Objective: Burn wound care procedures are very painful and lead to distress. Live music therapy has shown beneficial effects on distress and pain in specific pediatric patient populations. In this study we measured whether live music therapy has beneficial effects in terms of less distress and pain in children with burns after wound care procedures.

Pediatric surgeon density in South Africa.

Background: There are limited data regarding the available pediatric surgical workforce in South Africa and their employment prospects on completion of their specialist training.

Methods: This aim of this study was to quantify and analyze the pediatric surgical workforce in South Africa as well as to determine their geographic and sector distribution. This involved a quantitative descriptive analysis of all registered specialist as well as training pediatric surgeons in South Africa.

Massage has no observable effect on distress in children with burns: A randomized, observer-blinded trial.

Importance: In a previous observational study we found that massage therapy reduced anxiety and stress in pediatric burn patients. We aimed to test this effect in a randomized controlled trial.

Objective: To determine whether (1) aromatherapy massage can provide relaxation to hospitalized children with burns; (2) massage with aromatherapy oil is more effective than without; and (3) massage sessions are more effective when repeated.

Assessing and addressing the problem of pain and distress during wound care procedures in paediatric patients with burns.

Objective: While the prevalence of burns in children is highest in low and middle-income countries, most research on burn-related pain intensity and distress is carried out in high-income countries. In this study we assessed pain intensity and distress in paediatric patients with burns undergoing wound care procedures without distraction and parental presence in a South-African children's hospital and sought to identify predictors for the outcomes.

Methods: This observational study, carried out as part of a randomized controlled trial, took place at a burns unit in Cape Town, South Africa and included patients between the ages of 0 and 13 years undergoing their first or second wound care procedure.

Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children's Hospital in Cape Town, South Africa.

Referral guidelines for burn care are meant to assist in decision-making as regards patient transfer and admissions to specialized units. Little is known, however, concerning how closely they are followed and whether they are linked to patient care. This is the object of the current study, focused on the paediatric burns centre of the Red Cross War Memorial Children's Hospital in Cape Town, South Africa.

Total body and hand surface area: Measurements, calculations, and comparisons in ethnically diverse children in South Africa.

Aim: The aim was to investigate hand surface as a percentage of body surface area from infancy to 13 years of age using physical measurement and digital planimetry and establish the influence of age, gender, BMI for age and ethnicity, specifically in the South African population. A secondary aim included the development of a template for burn size measurement.

Methodology: This was a cross-sectional observational study.

'Getting under our skin': Introducing banked allograft skin to burn surgery in South Africa.

Deceased donor skin possesses many of the properties of the ideal biological dressing, and a well-stocked skin bank has become a critically important asset for the modern burn surgeon. Without it, managing patients with extensive burns and wounds becomes far more challenging, and outcomes are significantly worse. With the recent establishment of such a bank in South Africa, the challenge facing the medical fraternity is to facilitate tissue donation so that allograft skin supply can match the enormous demand.

Parent knowledge on paediatric burn prevention related to the home environment.

Introduction: Burns amongst children in South Africa are common and usually occur in the immediate home environment. In surveys many parents have requested ongoing educational burn prevention programs. This exploratory thematic parent orientation study assessed the level of parental knowledge on burn prevention strategies in the home.

The case of the exploding egg.

The vast majority of paediatric burns occur in developing countries, and many of these injuries are entirely preventable. In general, four paediatric injury patterns have been identified in toddlers and infants, who are at a significantly increased risk of burn injuries. Children <2 years of age are often innocent bystanders, but as they grow older physical mobility, social independence and gender-specific high-risk activities come into play.

Biofilms associated with bowel necrosis: A newly recognised phenomenon in infants.

Background: A biofilm is defined as a collection of organisms attached to a surface and surrounded by a matrix.

Objective: To present three cases in which bowel necrosis coexisted with biofilm.

Methods: The medical records, bacteriological findings and tissue biopsies from three infants with bowel necrosis who subsequently died from sepsis were analysed.

Burn surgeons in South Africa: A rare species.

Background: The high burden of burn injuries in South Africa (SA) requires surgeons skilled in burn care. However, there are few dedicated burn surgeons and properly equipped units or centres.

Objectives: To quantify the involvement of surgeons in burn care in SA hospitals, identify factors that attract surgeons to pursue burn care as a career and deter them from doing so, and understand the challenges of hospitals treating burn patients around the country.

Acticoat™ stimulates inflammation, but does not delay healing, in acute full-thickness excisional wounds.

Acticoat™ has antimicrobial and anti-inflammatory effects which aid wound healing. However, in vitro studies indicate that Acticoat™ is cytotoxic and clinical and in vivo studies suggest that it may delay healing in acute wounds. Therefore, this study investigated the effects of Acticoat™ on healing in acute full-thickness excisional wounds.

Ventilator associated pneumonia in major paediatric burns.

More than three-quarters of deaths related to major burns are a consequence of infection, which is frequently ventilator associated pneumonia (VAP). A retrospective study was performed, over a five-year period, of ventilated children with major burns. 92 patients were included in the study; their mean age was 3.

Pseudomonas aeruginosa burn wound infection in a dedicated paediatric burns unit.

Background: Pseudomonas aeruginosa infection is a major cause of morbidity in burns patients. There is a paucity of publications dealing with this infection in the paediatric population. We describe the incidence, microbiology and impact of P.

Our surgical heritage: the role of the Department of Paediatric Surgery in the development of paediatric surgery in Cape Town, in Africa, and around the world.

The Department of Paediatric Surgery at the University of Cape Town has made a remarkable contribution to the academic body of knowledge of Paediatric Surgery both in South Africa and around the world. It has played a key role in the development of the specialty in South Africa and through the South African diaspora has trained many paediatric surgeons who have made their mark internationally. More recently it has become a major focus of teaching and training for African paediatric surgeons.

Pediatric trauma care in Africa: the evolution and challenges.

Childhood trauma is one of the major health problems in the world. Although pediatric trauma is a global phenomenon in low- and middle-income countries, sub-Saharan countries are disproportionally affected. We reviewed the available literature relevant to pediatric trauma in Africa using the MEDLINE database, local libraries, and personal contacts.