What type of burns can usually be supported by an oral high protein, high calorie diet in children?

• A. Burns with inhalation injury
• B. Large burns (> 30% TBSA)
• C. Small burns (< 20% TBSA) not complicated by facial injury, psychologic problems, inhalation injury or pre-burn malnutrition
• D. Burns with facial injury

Answer: (C)

In pediatric burn care, the amount of calories and protein needed rises with wound healing, but how you meet those needs depends on burn size and complications. Small burns involving less than 20% of body surface area, when there isn’t facial injury, inhalation injury, or pre-burn malnutrition, can usually be managed with an oral, high-protein, high-calorie diet. These kids can typically tolerate oral intake and receive enough energy and nitrogen for tissue repair from food and supplements.

Larger burns or burns with inhalation injury, facial injury, or pre-existing malnutrition create greater metabolic stress and often limit oral intake, so we look to enteral (tube feeding) or even parenteral nutrition to ensure adequate calories and protein are delivered for healing.