Newswise — Burns in children are a complex and all-too common injury requiring coordinated care to achieve good medical, functional, and psychological outcomes. A thorough update in a wide range of areas affecting treatment and rehabilitation for "The Burned Child" is presented in a special topic section of the July Journal of Craniofacial Surgery. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.
The special section is presented by the American Association of Pediatric Plastic Surgery, together with the American Academy of Pediatrics Section on Plastic Surgery. "Unfortunately, burns are a relatively common clinical phenomenon encountered worldwide especially within the pediatric age group," writes Section Editor Dr. Seth Thaller of University of Miami School of Medicine in an introductory editorial. "Acute management and long-term management and reconstruction can present a considerable clinical challenge to even the most experienced practitioner in plastic surgery and to the pediatric plastic surgeon."
Written by leading experts in their fields, the special study comprised of 29 papers present current perspectives on the many and complex aspects of care for children with burns, ranging from nonsurgical treatment of mild burns to acute medical care, surgical reconstruction, and long-term rehabilitation for severe burns. The special section provides a broad-ranging update for all surgeons involved in caring for the burned child.
Papers Address Infection Risk, Burn Coverage, and MoreBurns are complex injuries that, when severe, can disrupt many body systems. This is especially true for children, in whom burns can easily involve a large percentage of the body surface area. For example, several papers in the special section address two interrelated issues: the risk of infection and the challenge of providing coverage of skin areas destroyed by burns.
Even with modern medical care, infection is still the leading cause of death after burns. Because burns disrupt the normal protective function of the skin, colonization with bacteria or other organisms can rapidly lead to widespread infection (sepsis). Prompt surgery, the use of antimicrobial dressings, and skin grafts to replace the burned skin are essential to controlling infection risk. New "bio-occlusive" and hybrid dressings have taken on an increasingly important role in the management of children with burns.
Advances in cellular biology have led to new biomaterials, offering potentially valuable approaches to covering large areas of burned skin destroyed by burns. Promising techniques attempting to mimic the body's natural cellular repair mechanisms, disrupted after burn injuries, are being investigated as well.
Other papers in the special section review approaches to reconstructive surgery after severe burns in children. Topics include the special challenges of burns in specific areas—for example, the hands or face. Careful planning and repeated surgeries are needed to provide "resurfacing" of facial burns, avoiding complications related to contractures and scarring as the child grows. After acute care and reconstructive surgery, psychological follow-up is an important part of care for burned children. Particularly after disfiguring burns of the face, the growing child's sense of identity can be disrupted, increasing the risk of emotional and psychological problems. Long-term follow-up in the form of psychological rehabilitation is essential, involving coordinated efforts by the multidisciplinary burn care team, school, and the family and child.
In an accompanying editorial, Dr. Mutaz B. Habal, Director of Tampa Bay Craniofacial Center in Tampa, Fla. and Editor-in-Chief of JCS, reflects on progress made in the treatment and rehabilitation of burned children in his experience as a plastic surgeon, along with the challenges still ahead. "Initially, patient outcome was measured by survival rate, but subsequently success is measured and evaluated by improvement of the functional outcome of survivors," Dr. Habal writes.
About The Journal of Craniofacial SurgeryThe Journal of Craniofacial Surgery (http://www.jcraniofacialsurgery.com) serves as a forum of communication for all those involved in craniofacial and maxillofacial surgery. Coverage ranges from practical aspects of craniofacial surgery to the basic science that underlies surgical practice. Affiliates include 13 major specialty societies around the world, including the American Association of Pediatric Plastic Surgeons, the American Academy of Pediatrics Section of Pediatric Plastic Surgery, the American Society of Craniofacial Surgeons, the American Society of Maxillofacial Surgeons, the Argentine Society of Plastic Surgery Section of Pediatric Plastic Surgery, the Asian Pacific Craniofacial Association, the Brazilian Society of Craniofacial Surgeons, the European Society of Craniofacial Surgery, the International Society of Craniofacial Surgery, the Japanese Society of Craniofacial Surgery, the Korean Society of Craniofacial Surgery, the Thai Cleft and Craniofacial Association, and the World Craniofacial Foundation.
About Lippincott Williams & Wilkins Lippincott Williams & Wilkins (www.LWW.com) is a leading international publisher for healthcare professionals and students with nearly 300 periodicals and 1,500 books in more than 100 disciplines publishing under the LWW brand, as well as content-based sites and online corporate and customer services. LWW is part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.
Wolters Kluwer Health is a division of Wolters Kluwer, a leading global information services and publishing company with annual revenues (2007) of €3.4 billion ($4.8 billion), maintains operations in over 33 countries across Europe, North America, and Asia Pacific and employs approximately 19,500 people worldwide. Visit www.wolterskluwer.com for information about our market positions, customers, brands, and organization.
RSS