Pediatric surgery international
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Patients with severe burn injury are a challenge for the pediatric anesthesiologist. Today with adequate care many children survive their trauma and have a good chance for complete functional and psychological rehabilitation. The anesthesiologist has to provide excellent care even for patients in suboptimal or unstable condition to enable wound debridement and grafting, because only rapid skin closure will stabilize the patient. Adequate pain treatment during all phases of burn treatment is mandatory.
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Active basic-science investigations and directed clinical research have resulted in effective therapies for improving the outcomes of burned children. Major areas of inquiry have been in resuscitation, hypermetabolism, wound coverage, and inhalation injury, all of which have yielded fruitful results. Probably the most important advance has been the widespread use of early excision and grafting, which has changed the pathophysiology of burn injury. Further advances in the fields of metabolism, wound healing, and respiratory medicine may improve results even further, particularily in functional and cosmetic outcomes.