Child abuse by burning: A review of the literature and an algorithm for medical investigations

Background: Investigations of suspected child abuse must be conducted thoroughly to protect the abused child and to bring the abuser to trial. We have reviewed the literature on child abuse by burning and have synthesized, from the experience of ourselves and others, an algorithm that can be used by physicians, social workers, and nurses involved in the investigation of alleged child abuse by burning. Methods: A MEDLINE search was conducted for the years 1966 through 2000 for human studies written in the English language using the key terms "child abuse" and "burns." Results: Information from these articles was reviewed and included in this article. On the basis of our own experience and that cited in the literature, an algorithm was constructed to guide hospital-based personnel in their management of child abuse by burning. Conclusion: Medical investigation of suspected child abuse by burning can be performed systematically using an algorithm, thereby minimizing the chance of either false-positive or false-negative reporting.