The Changing Landscape of Pediatric Burns in the United Kingdom: A 20-Year Epidemiological Study

Burns are a leading cause of childhood injury. Analysis of pediatric burn epidemiology is essential for targeting educational and public health strategies but there is limited available UK data, particularly traversing the COVID-19 pandemic. We hypothesize that the last 20 years have seen significant changes in injury patterns and service provision, with a marked effect from national lockdown measures. This study aims to describe the epidemiology of pediatric burns referrals and admissions within a pediatric burns unit in the UK over 20 years (2005-2024). A retrospective analysis was performed for pediatric patients referred to our center between 2005 and 2024. The International Burn Injury Database (iBID) was used to extract demographic and injury information. Data before, during and after COVID-19 lockdown periods was compared. 6919 patients met the inclusion criteria. 1872 (27.1%) of patients required admission. There was a significant reduction in admission rate following covid despite an increase in average TBSA (p<0.01). Most cases were scalds (n=3100, 44.8%) or contact burns (n=2650, 38.3%). The majority of patients were aged under 5 years (n=4529, 65.5%), with a rise in referrals for older children across the study period. There was a noticeable rise in aerosol-related flash burns, cold burns and treadmill- related friction burns during and after the pandemic. This study provides epidemiological data for the development of public health initiatives and adaptation of pediatric burns services. Emerging mechanistic trends and service re-design following the COVID pandemic requires further multi-center evaluation to inform future care.