The Journal of craniofacial surgery
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Burn injuries continue to be a significant cause of pediatric morbidity in the United States, with approximately 20,000 admissions per year to centers specializing in the treatment of burn injuries. In this article, we aim to provide the practitioner with a guideline to the unique challenges, advances and current expectations, and treatment in this patient population.
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Severe burn injuries frequently present a therapeutic challenge; fortunately, conservative therapies have proven highly effective in augmenting standard surgical management. Skin substitutes, such as pigskin or cadaveric tissue, aid in acute burn care by limiting fluid and heat loss. ⋯ Physical therapy promotes strengthening of local musculature and regain range of motion. We discuss the nonoperative management of severe burns, as well as provide insight into future directions in conservative burn care.
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Neck deformities remain a cause of significant morbidity in children who sustain burns. Reconstructive efforts must be directed not only at restoring satisfactory head position, flexion/extension, and rotation but also at satisfying the cosmetic and functional needs of the individual patient. We present the management of these complex patients, from the acute management of neck burns to the various reconstructive options available.
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Fluid resuscitation after thermal injury in a child or infant can pose a set of unique and significant challenges. Many approaches to fluid resuscitation of children after burns exist, and most are nonevidence based. This review will highlight the important concepts involved in pediatric fluid resuscitation from thermal injury.
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Pediatric patients account for approximately one third of all burn patients in the United States, with upper extremity or hand involvement in most admitted burn patients. Specialized management and care of pediatric burn patients optimizes functional outcomes. ⋯ Acute and long-term care aspects of pediatric upper extremity and hand burns require unique considerations. Diagnosis, treatment, and management of upper extremity and hand burns are discussed in detail with respect to the pediatric population.