What are the Differences? - Treatment of Burns in Children Compared to Treatment in Adults

 

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Abstract

Burns in children are very common. In this article we would like to focus on those aspects of wound care and surgical treatment in burns which are special in the paediatric population. Especially in small children it is crucial to correctly estimate a burned area and to delay appropriate fluid resuscitation. Pain management in children is very important, we therefore recommend standing pain orders managed by the nursing team. Wound care should be as little stressful as possible and enable an excellent evaluation of the wound. Surgical coverage is needed in less than 40% of all scald paediatric injuries and should be done with unmeshed split thickness skin from the scalp. In major and massive burns in children one should opt for an aggressive excision of all deep burned areas within the first 4 to 5 days and for a temporary wound coverage before replacing it with meshed autologous skin transplantations and/or keratinocyte sheet grafts. Finally, rehabilitation is very important, it starts at the day of trauma and needs a multidisciplinary approach. Parents have to be involved early, need to be well taught and well trained to guarantee excellent long-term results in a growing child.

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Correspondence

Clemens SchiestlM.D. 

Department of Surgery

Paediatric Burn Centre

Plastic and Reconstructive Surgery

University Children's Hospital

Steinwiesstr. 75

8032 Zurich

Switzerland

Phone: +41/44/266 71 11

Fax: +41/44/266 71 71

Email: clemens.schiestl@kispi.unizh.ch