Reconstruction of the pediatric burned hand.

Though the hand constitutes only 3% of the total body surface area, a burned hand is a major injury. Reconstruction of the burned hand is key to the overall rehabilitation of the burned patient. Whether an isolated injury, or part of burns to a large overall body surface area, loss of the hand represents a major functional impairment.

Microvascular transfer of burned tissue for mandibular reconstruction.

We present a case of mandibular reconstruction using a free-vascularized fibula osteocutaneous flap after invasive infection of the mandible with mucormycosis. Unique to this case is the skin paddle that previously sustained full-thickness burn injury treated with cultured skin substitute (CSS). A 10-year-old boy sustained a 96% total body surface area burn.

Management of class IV skull burns using the bipedicled superficial temporal artery scalp flap.

Calvarial burns are extremely rare and pose a difficult challenge for both the burn and reconstructive surgeon. Reconstruction of these injuries is dependent on the depth of invasion and the amount of tissue loss. Fourth-degree burns include damage to the calvarium and the underlying dura and or cerebrum.

Early use of allograft skin: are 3-day microbiologic cultures safe?

Background: Under the guidance of the American Association of Tissue Banks and the Food and Drug Administration, the use of allograft skin is safer than ever. In addition to the donor selection process and serology studies, current practice is to wait until 7 days of negative microbiologic cultures are completed before use. However, we have used 3 days of negative cultures in special cases as needed for clinical use.

A survey of current rehabilitation trends for burn injuries to the head and neck.

Burn injuries to the face and neck present a unique challenge to the burn team and must be treated with considerable care and vigilance by the rehabilitation team to prevent potential contractures that may occur. Standard guidelines for treatment of the head and neck have not been established. This article presents the results of a comprehensive survey that examined the similarities and differences in the rehabilitation techniques used in various burn centers for the treatment of these injuries.

Management of postburn recalcitrant knee ulcers in pediatric patients.

The sequelae of severe lower-extremity burn injuries in children include ulcerations and unstable scars of the anterior knee. Although the weight-bearing and ambulatory demands on this joint predispose the ulcers to chronicity, recalcitrance to treatment in the absence of systemic factors may be indicative of the presence of less-than-optimal local factors mitigating against healing. In our experience, excessive skin tightness around the knee joint has played a key role in this respect.

Management of acute calvarial burns in children.

Background: Although rare, head burns involving the calvarium are a serious complication of burns and electrical injury, and present therapeutic challenges to the surgical burn care team. We evaluated our experiences and compared available strategies to address this challenge.

Methods: Records of all burned children between January 1986 and December 2000 were reviewed.

Burn scar contractures of the feet: efficacy of bilateral simultaneous surgical correction.

Children who sustain large total body surface area (TBSA) burns with involvement of the lower extremities frequently sustain injuries to the dorsum of the feet. Burn scar contractures of the feet can develop as a sequela of the burn injury. Such contractures frequently require surgical correction.

The development, validation, and testing of a health outcomes burn questionnaire for infants and children 5 years of age and younger: American Burn Association/Shriners Hospitals for Children.

The 12-member American Burn Association/Shriners Hospitals for Children Outcomes Task Force was charged with developing a health outcomes questionnaire for use in children 5 years of age and younger that was clinically based and valid. A 55-item form was tested using a cross-sectional design on the basis of a range of 184 infants and children between 0 and 5 years of age at 8 burn centers, nationally. A total of 131 subjects completed a follow-up health outcomes questionnaire 6 months after the baseline assessment.