International Journal of Legal Medicine

, Volume 124, Issue 1, pp 49–54

Violence against children: further evidence suggesting a relationship between burns, scalds, and the additional injuries

  • Dragana Seifert
  • Julia Krohn
  • Mandi Larson
  • Andrea Lambe
  • Klaus Püschel
  • Henrike Kurth
Original Article


Up to 22 % of all child maltreatment cases involve non-accidental burns or scalds. In the time period of 2000 until 2007, 20 children with non-accidental burns and scalds in conjunction with other mechanisms of injury were examined at children’s hospitals in Hamburg and at the Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, by experts in forensic medicine. The fact that these children presented with additional injuries due to blunt and sharp force and sometimes had signs of neglect emphasize the urgent need for a multidisciplinary cooperation between pediatricians and forensic medical experts to ensure the early identification and prevention of child maltreatment. A new approach for Germany, enforcing mandatory child well-being examinations is discussed.


Child maltreatment Non-accidental burns or scalds Prevention Violence against children 


  1. 1.
    Renz BM, Sherman R (1992) Child abuse by scalding. J Med Assoc Ga 81:574–578PubMedGoogle Scholar
  2. 2.
    Peck MD, Priolo-Kapel D (2002) Child abuse by burning: a review of the literature and an algorithm for medical investigations. J Trauma 53:1013–1022CrossRefPubMedGoogle Scholar
  3. 3.
    Hermann B (2002) Child physical abuse. Physical findings and medical diagnosis. Monatsschr Kinderheilkd 150:1324–1338CrossRefGoogle Scholar
  4. 4.
    Hermann B (2005) Medizinische Diagnostik bei Kindesmisshandlungen. In: Deegener G, Körner W (eds) (Hrsg) Kindesmisshandlung und Vernachlässigung. Hogrefe, Göttingen, pp 446–465Google Scholar
  5. 5.
    Hobbs CJ (1986) When are burns not accidental? Arch Dis Child 61:357–361CrossRefPubMedGoogle Scholar
  6. 6.
    Rosenberg NM, Marino D (1989) Frequency of suspected abuse/neglect in burn patients. Pediatr Emerg Care 5:219–221PubMedCrossRefGoogle Scholar
  7. 7.
    Keen JH, Lendrum J, Wolman B (1975) Inflicted burns and scalds in children. Br Med J 4:268–269CrossRefPubMedGoogle Scholar
  8. 8.
    Hermann B, Dettmeyer R, Banaschak S, Thyen U (2008) Hautbefunde. Kindesmisshandlung, Medizinische Diagnostik, Intervention und rechtliche Grundlagen. Springer, Berlin, Heidelberg New York, p 62Google Scholar
  9. 9.
    Allasio D, Fischer H (2005) Immersion scald burns and the ability of young children to climb into a bathtub. Pediatrics 115:1419–1421CrossRefPubMedGoogle Scholar
  10. 10.
    Bennett B, Gamelli R (1998) Profile of an abused burned child. J Burn Care Rehabil 19:88–94CrossRefPubMedGoogle Scholar
  11. 11.
    Hicks RA, Stolfi A (2007) Skeletal surveys in children with burns caused by child abuse. Pediatr Emerg Care 23:308–313CrossRefPubMedGoogle Scholar
  12. 12.
    Oates AM, RK PJ, Spalding S, Martin H (1998) Non-accidental burns in children. Burns 24:552–558CrossRefPubMedGoogle Scholar
  13. 13.
    Lenoski EF, Hunter KA (1977) Specific patterns of inflicted burn injuries. J Trauma 17:842–846CrossRefPubMedGoogle Scholar
  14. 14.
    Höger H (2007) Kinderdermatologie: Differenzialdiagnostik und Therapie bei Kindern und Jugendlichen, 2. Auflage. Schattauer, Stuttgart, pp 496–501Google Scholar
  15. 15.
    Raimer BG, Raimer SS, Hebeler JR (1981) Cutaneous signs of child abuse. J Am Acad Dermatol 5:203–212CrossRefPubMedGoogle Scholar
  16. 16.
    Leventhal JM, Griffin D, Duncan KO, Starling S, Christian CW, Kutz T (2001) Laxative-induced dermatitis of the buttocks incorrectly suspected to be abusive burns. Pediatrics 107:178–179CrossRefPubMedGoogle Scholar
  17. 17.
    Feldman KW (1995) Confusion of innocent pressure injuries with inflicted dry contact burns. Clin Pediatr (Phila) 34(2):114–115CrossRefGoogle Scholar
  18. 18.
    Mücke KH, Beushausen T (2007) Verbrühung und Verbrennung im Kindesalter. Notfall Rettungsmed 4:184–188Google Scholar
  19. 19.
    Feldman KW, Schaller RT, Feldman JA, McMillon M (1998) Tap water scald burns in children. Inj Prev 4:238–242CrossRefPubMedGoogle Scholar
  20. 20.
    Kellogg ND (2007) Committee on child abuse and neglect, evaluation of suspected child physical abuse. Pediatrics 119:1232–1241CrossRefPubMedGoogle Scholar
  21. 21.
    Dubowitz H, Bennett S (2007) Physical abuse and neglect of children. Lancet 369:1891–1899CrossRefPubMedGoogle Scholar
  22. 22.
    Darok M, Reischle S (2001) Burn injuries caused by a hair-dryer—an unusual case of child abuse. Forensic Sci Int 115:143–146CrossRefPubMedGoogle Scholar
  23. 23.
    Skellern CY, Wood DO, Murphy A, Crawford M (2000) Nonaccidental fractures in infants: risk of further abuse. J Paediatr Child Health 36:590–592CrossRefPubMedGoogle Scholar
  24. 24.
    Theodore AD, Runyan DK (1999) A medical research agenda for child maltreatment: negotiating the next steps. Pediatrics 104:168–177PubMedGoogle Scholar
  25. 25.
    Martrille L, Cattaneo C, Dorandeu A, Baccino E (2006) A multicentre and prospective study of suspected cases of child physical abuse. Int J Legal Med 120:73–78CrossRefPubMedGoogle Scholar
  26. 26.
    Kumar P (1984) Child abuse by thermal injury—a retrospective survey. Burns 10:344–348CrossRefGoogle Scholar
  27. 27.
    Entwurf eines Gesetzes zur Verbesserung des Kinderschutzes (Kinderschutzgesetz), Bundesratsdrucksache 59/09 vom 23.01.09.
  28. 28.
    Stellungnahme der Bundesregierung zu der Entschließung des Bundesrates für eine Ausweitung und Qualifizierung der Früherkennungsuntersuchungen im Sinne des Kindeswohls. Drucksache 374/07 vom 25. Mai

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Dragana Seifert
    • 1
  • Julia Krohn
    • 1
  • Mandi Larson
    • 1
  • Andrea Lambe
    • 1
  • Klaus Püschel
    • 1
  • Henrike Kurth
    • 1
    • 2
  1. 1.Department of Legal MedicineUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of PediatricsUniversity Medical Center Hamburg-EppendorfHamburgGermany

Personalised recommendations