{"title":"Musculoskeletal Issues in Pediatric Burn Patients","authors":"William A. Phillips","doi":"10.1055/s-0044-1782651","DOIUrl":"https://doi.org/10.1055/s-0044-1782651","url":null,"abstract":"<p>A burn injury affects virtually every organ system. The purpose of this article is to review musculoskeletal issues in children with burn injuries. Both acute and long-term problems will be discussed. A low threshold to consult a pediatric orthopaedist is recommended.</p>","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"175 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140803642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pediatric Burn Teams: Moving from Multidisciplinary to Transdisciplinary","authors":"Kathleen S. Romanowski","doi":"10.1055/s-0044-1782644","DOIUrl":"https://doi.org/10.1055/s-0044-1782644","url":null,"abstract":"<p>Pediatric burn care has improved to the point where even patients with massive burns have a reasonable chance of survival. An important component of this success is the pediatric multidisciplinary burn team. The pediatric burn team is made up of all the disciplines that are required to provide optimal care of the patient as well as their family. The pediatric burn team in its initial iteration was multidisciplinary, with each discipline focusing on their own area without much overlap. However, over time the burn team has become more cooperative and interdisciplinary leading to improved outcomes for children with burn injuries. Ultimately, pediatric burn teams may be able to function in a transdisciplinary manner which would potentially allow for even more innovation in the care of burn patients.</p> ","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"25 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140576042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael J. Erickson, Perenlei Enkhbaatar, Jong O. Lee
{"title":"Inhalation Injury","authors":"Michael J. Erickson, Perenlei Enkhbaatar, Jong O. Lee","doi":"10.1055/s-0044-1782646","DOIUrl":"https://doi.org/10.1055/s-0044-1782646","url":null,"abstract":"<p>Inhalation injury is a critical component of thermal injury that can significantly increase mortality in burn survivors. This poses significant challenges to managing these patients and profoundly impacts patient outcomes. This comprehensive literature review delves into the epidemiology, pathophysiology, diagnosis, classification, management, and outcomes of inhalation injury with burns.</p> ","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"17 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140576243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Initial Pediatric Burn Management: A Practical Guide","authors":"Tina L. Palmieri","doi":"10.1055/s-0044-1782645","DOIUrl":"https://doi.org/10.1055/s-0044-1782645","url":null,"abstract":"<p>Children have an imperative to explore their environment to grow and develop, which puts them at risk for sustaining burn injury. Burn injury remains the third leading cause of injury-related death worldwide. Plastic surgeons, as experts in the evaluation and management of cutaneous injuries, are frequently called upon to evaluate and treat children with burn injuries. This article focuses on the unique physiologic aspects of children and how they impact initial evaluation and management of burn injury. Children are not “little adults,” and they have different airway, circulatory, and cutaneous systems. Understanding the signs of potential child abuse is important to avoid further child harm. Finally, recognition of the criteria for referral to a pediatric burn center is important to optimize both short- and long-term outcomes for patients and families.</p> ","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"40 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140576238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nutrition in Pediatric Burns","authors":"Amy A. Mrazek, Preston Simpson, Jong O. Lee","doi":"10.1055/s-0044-1782648","DOIUrl":"https://doi.org/10.1055/s-0044-1782648","url":null,"abstract":"<p>Nutrition and modulation of the hypermetabolic response to acute burns are reviewed in this article. Methods to determine caloric requirements are evaluated, including indirect calorimetry and predictive equations. Individual nutritional components of carbohydrates, fat, protein, vitamins, and trace elements are discussed specifically in relation to acute burn care. Selection of formula and route of administration are outlined, with an enteral high-carbohydrate, low-fat diet being preferable. Awareness and recognition of the signs and symptoms of malnutrition is critical in the management of variable caloric needs throughout hospitalization. Lastly, the catabolic state of acute burns is addressed through early excision and grafting and implementation of various pharmacologic agents, including growth hormone, insulin-like growth factor-1, insulin-like growth factor-binding protein-3, insulin, propranolol, and oxandrolone. Through a multipronged approach to nutrition, pediatric burn patients are provided the substrates for successful recovery and rehabilitation.</p> ","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"438 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140602632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ramon L. Zapata-Sirvent, Ludwik K. Branski, Jong O. LEE
{"title":"Global Surgery: Burn Outreach by Shriners Children's Texas","authors":"Ramon L. Zapata-Sirvent, Ludwik K. Branski, Jong O. LEE","doi":"10.1055/s-0044-1785217","DOIUrl":"https://doi.org/10.1055/s-0044-1785217","url":null,"abstract":"<p>Global surgery describes a rapidly developing field that seeks to improve surgical treatment internationally, specifically in those specialized treatments that are not readily accessible, considered complex and expensive. Burns cause 300,000 deaths annually, 90% of which occur in low- and middle-income countries (LMICs).</p> <p>Burns are a public health problem since they can cause disability and death. Shriners Children's Texas is a unique model of global surgery for an important number of countries in Central and South Americas and Mexico, providing specialized acute burn care with low mortality for burned children.</p> <p>Survivors of severe burns may face devastating sequelae due to burn scar contractures and hypertrophic burn scars that may limit the social reintegration. Burn reconstruction is not easily accessible to patients in LMICs. After discharge from acute burn treatment at our hospital, patients may return every 6 months for in-person follow-up to assess any surgical, psychological, or rehabilitative needs. Telemedicine allows for monitoring of postoperative results and evaluation for new surgical procedures. Follow-up clinic visits called outreach clinics held in international hospitals or international Shriners Temples allow for evaluation of follow-up patients and new patients with reconstructive needs that may benefit from a treatment in Shriners Children's Texas in Galveston, Texas.</p> ","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"89 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140576251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julia Kleinhapl, Kristine Knappskog, Celeste C. Finnerty, Ludwik Branski, Oscar E. Suman
{"title":"The Historical Evolvement of Movement and Exercise Training in Patients with Severe Burns and Their Potential Effects on Grafts, Scars, and Function","authors":"Julia Kleinhapl, Kristine Knappskog, Celeste C. Finnerty, Ludwik Branski, Oscar E. Suman","doi":"10.1055/s-0044-1785216","DOIUrl":"https://doi.org/10.1055/s-0044-1785216","url":null,"abstract":"<p>Exercise training for burn patients has become a major part of rehabilitation programs within the last decades. One of the main reasons for prolonged and long-term increased morbidity and mortality in this population is a persistent catabolic state with subsequent loss of lean body mass (LBM). A combination of resistance and aerobic exercises as well as stretching has shown to improve physical function by enhancing cardiopulmonary fitness, LBM, and strength and thus leading to ameliorated long-term outcomes of patients recovering from burns. In this literature review, we show an outline of the implementation of exercise training over the last decades into standardized care for patients with burns.</p> ","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"54 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140576110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah A. Layon, Austin D. Williams, Matthew J. Parham, Jong O. Lee
{"title":"Update on Hypermetabolism in Pediatric Burn Patients","authors":"Sarah A. Layon, Austin D. Williams, Matthew J. Parham, Jong O. Lee","doi":"10.1055/s-0044-1782649","DOIUrl":"https://doi.org/10.1055/s-0044-1782649","url":null,"abstract":"<p>Despite advancements in pediatric burn care, the profound hypermetabolic response associated with severe burns remains a multifaceted challenge throughout the continuum of care. Understanding the various physiologic disturbances that constitute hypermetabolism is crucial for a thorough evaluation and for implementing appropriate surgical and nonsurgical interventions. In this article, we describe the pathophysiology and treatment of hypermetabolism in pediatric burn patients with a focus on reducing resting energy requirements, minimizing infection, and optimizing nutrition for patients undergoing frequent surgical intervention.</p> ","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"41 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140576008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marta Rosenberg, Robert Rodriguez, Staci Grant, Alicia San Miguel, Jong O. Lee, Laura Rosenberg
{"title":"Benefits and Process of Providing Peer Support for Pediatric Burn Survivors and Caregivers during Inpatient and Outpatient Phases of Recovery","authors":"Marta Rosenberg, Robert Rodriguez, Staci Grant, Alicia San Miguel, Jong O. Lee, Laura Rosenberg","doi":"10.1055/s-0044-1782650","DOIUrl":"https://doi.org/10.1055/s-0044-1782650","url":null,"abstract":"<p>The World Health Organization reveals that pediatric burns represent a large portion of burns globally (61). Increases in survival rates have guided clinical and research focus on physical, psychological, and social outcomes. Research on other childhood illnesses has shown the efficacy of social support throughout recovery. In the pediatric burn literature, studies have shown the efficacy of burn camps for promoting positive interactions among survivors, learning coping skills, and facilitating socialization and reintegration. However, few studies have focused on the benefits of peer support for pediatric burn survivors and their caregivers in the inpatient and outpatient phases of recovery. This descriptive paper identifies options for building resilience for pediatric burn survivors through peer support in the inpatient and outpatient phases of recovery. The authors discuss options for providing peer support during the coronavirus disease 2019 pandemic on the pediatric intensive care unit, general pediatric floor, and outpatient setting.</p> ","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"251 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140576114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Wound Management of Pediatric Burns","authors":"David G. Greenhalgh","doi":"10.1055/s-0044-1785215","DOIUrl":"https://doi.org/10.1055/s-0044-1785215","url":null,"abstract":"<p>The goal for treating pediatric burns is to allow the patient to heal with as little scarring as possible. Compared to older children and adults, very small children have anatomic differences that alter their treatment. They have thinner skin that leads to a higher risk for full-thickness burns. Children also tend to freeze when touching a hot item, so that the prolonged contact also leads to deeper burns. Two healing strategies are needed to treat these wounds. One must optimize reepithelialization in superficial burns to reduce scarring. Deeper burns require skin grafting, but there are techniques, such as the use of “sheet” autograft skin that lead to excellent outcomes. Strategies to treat the massive pediatric burn will also be covered. Finally, there are instances where different strategies are needed to cover exposed bone or tendon. The ultimate goal is to return the skin to as normal a state as possible.</p> ","PeriodicalId":48687,"journal":{"name":"Seminars in Plastic Surgery","volume":"230 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140576242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}