Chronic Wounds in Children: Prevalence, Aetiological Types and Predilection Sites in a Rural Setting in an Emerging Economy

  • Usang E Usang Divisions of Paediatric Surgery, Department of Surgery, UCTH, Calabar, Nigeria
  • Otei O Otei Division of Plastic Surgery, Department of Surgery, UCTH, Calabar, Nigeria
  • Akan W Inyang Divisions of Paediatric Surgery, Department of Surgery, UCTH, Calabar, Nigeria
  • Okon A Eyo Department of Community Medicine, UCTH, Calabar, Nigeria
Keywords: Chronic wounds, Prevalence in children, Aetiological types, Predilection sites, Emerging economy.


The aim of this study was to determine the prevalence, aetiological types and predilection sites of chronic wounds in children. This study was a cross sectional study conducted on children aged 0-15 years. Through cluster sampling technique, children with wounds were recruited and evaluated. Demographic and clinical data were collected and analyzed. Descriptive statistics were used to summarize variables and Chi-squared test was used to achieve comparison between age groups and sexes. Statistical significance was defined as p<0.05. The results show that one thousand and ten children were screened for wounds out of which 107 children with 115 wounds were found. 16.5% of these wounds were chronic with a prevalence rate of 2.0%. Chronic wound prevalences in the school aged (47.4%) and adolescent (52.6%) children were 0.9% and 1.0% respectively (x2 = 0.821; p = 0.359 Yates’ corrected, Fisher’s exact test 2-sided) and statistically insignificant. 57.9% were caused by trauma and majority (89.5%) occurred in the lower limbs (x2=0.000; p=1.000 Yates’ corrected, Fisher’s exact test 2-sided) without any statistical significance. Prevalence of chronic wounds in the children population was very low. The commonest aetiological type was inadequately treated traumatic wounds which progressively healed on institution of appropriate wound treatment.


[1] Lazarus GS, Cooper DM, Knighton DR, Margolis DJ, Pacoro RE, Rodeheaver G et al (1994). Definitions and guidelines for assessment of wounds and evaluation of healing. Arch Dermatol vol 130: 489-493.
[2] Basu S, Shukla V (2010). Complications of wound healing. In: Mani R, Romanelli M, Shukla v (eds). Measurements in wound healing. Springer London pp 109-144.
[3] Garvin G (1990). Wound healing in Paediatrics. Nurs clin North Am vol 25: 181-192.
[4] Bale S, Jones V (1996). Caring for children with wounds. J. Wound care vol 5(4): 177-180.
[5] Van de Kerkhof PC, Van Bergen B, Spruijt K, Kuiper JP (1994). Age Related changes in would healing. Clin Exp Dermatol vol 19: 369-374.
[6] Sen CK, Gordillo GM, Roy S, kirsner R, Lambert L, Hunt TK et al (2009). Human skin wounds: A Major and snowballing threat to public Health and the Economy. Wound Repair Regen vol 17 (6): 763-771.
[7] Graces N, Zheng H (2014). Prevalence and incidence of chronic wounds; a literature review. Wound Practice and Research vol 22 (1): 4-16
[8] Semer NB (2001). Chronic wounds. In: Semer NB (ed). Practical plastic surgery for non- surgeons. Philadelphia. Hanley and Belfus, Inc. pp 172-181.
[9] Broughton G II, Jqanis JE, Attinger CE (2006). Wound healing: an overview. Plast Reconstr Surg vol 117: 1e-s -32e-s
[10] Pieper B, Templin T, Dobal M, Jacox. A (2000). Prevalence and types of wounds among children receiving care in the home. Ostomy / Wound Manage vol 46 (4): 36-42.
[11] Nigeria Demographic and Health Survey (NDHS) (2013). Household population and Housing characteristics. National Population Commission (NPC). Federal Republic of Nigeria, Abuja, Nigeria pp 11-29.
[12] Reddy Y, Ganie Y, Pillay K (2013). Characteristics of children presenting with newly diagnosed type 2 diabetes S. Afr J Ch vol 7 (2): 46-48.
[13] Hayes S, Dodds SR (2003). The identification and diagnosis of malignant leg ulcers. Wound Care vol 99 (31): 50.
[14] Diamantopoulos A, Schlegelmilch BB (1997). Getting experienced; making comparisons. In: Diamantopoulos A, Schlegelmilch BB (eds). Taking the fear out of data analysis. London, Dryden Press pp 172 – 197.
[15] Maffuli N, Via AG, Oliva F (2016). Acute lower extremity injury. Paediatric and Adolescent Sports. In: Caine D, Purcell L (eds). Injury in Paediatric and Adolescent Sports: Epidemiology, treatment and prevention. 1st ed. Springer pp 107-118.
[16] Falanga V (1993). Chronic wounds: pathophysiologic and experimental considerations. J Investigative Derma vol 100 (5): 721-725.
[17] Spentzouris G, Labropoulos N (2009). The evaluation of lower – extremity ulcers. Seminars in Interventional Radiology vol 26(4): 286-295.
[18] Bower KA, Mulder GD, Reineke A, Guide SV (2011). Dermatologic conditions and symptom control. In: Wolfe J, Hinds P, Sources B (eds). Textbook of Interdisciplinary Paediatr Palliative Care. Elsevier Saunders pp 350-367.
[19] Smith PF, Meadocroft AM, May DB (2000). Treating mammalian bite wounds. J Clin Pharm Ther vol 25:85-99.
[20] Jones H, Blinder M, Analkat M (2013). Cutaneous notations of sickle cell disease. Open Journal Blood Diseases vol 3: 94-99.
[21] Rehmani R (2008). Childhood injuries seen at an emergency department. J Pak Med Assoc vol 58: 114-118.
[22] Phelan KJ, Khoury J, Kalkwarf H, Lanphear B (2005). Residential injuries in US children and adolescents. Public Health Reports vol 120: 63-70.
[23] Mc Dermott-Scales L, Cowman S, Gethin G (2009). Prevalence of wounds in a community care setting in Ireland. J Wound Care vol 18 (910): 205-417.