Postburn sequelae in the pediatric patient: clinical presentations and treatment options.

Each year, more and more children acquire burns that require serious medical attention. A vast number of these burns lead to permanent disfigurement and long-term disability. As health care providers, focus should not only be on the immediate treatment, but also on the long-term outcome of these burns and the required rehabilitation that these burn patients must go through.

Lower-extremity burn reconstruction in the child.

Lower-extremity burns in a pediatric patient require special consideration. The management of burn reconstruction in pediatric patients is often complex, requiring multiple reconstructive operations, and the primary intention of the surgeon is to prevent burn scar deformities. Timely management of the burn wound and postburn scars has decreased the incidence of burn scar deformities and contractures of the lower extremity in recent years.

Early management of the burned pediatric hand.

Unique anatomic and pathophysiologic features of the thermally burned pediatric hand are reviewed, with a focus on direct management of the injured tissue in the early phases of the treatment process. A nonoperative approach to most pediatric hand burns is advocated, and principles of early wound care, including antimicrobial therapy, and escharotomy are described. Specific emphasis is placed on distinctive characteristics of the fifth digit which make it prone to contracture patterns resembling a boutonniere-type deformity and on newer wound care technologies that simplify the application process without loss of antimicrobial and barrier function.

Obesity alters rat abdominal flap survival.

Obesity presents a risk factor for flap-related complications in autologous tissue breast reconstruction. In this study, an animal model was developed to examine this phenomenon. Abdominal flaps based on a superficial inferior epigastric pedicle were elevated in an experimental group of obese Zucker (fa/fa) rats (n = 8; mean weight, 413 g) and in their lean littermates (n = 9; mean weight, 276 g).

Case report: cleft palate closure in 18-month-old female with epidermolysis bullosa.

In a patient with epidermolysis bullosa and cleft palate, perioperative guidelines and surgical management can be unclear. This case report illustrates the occurrence of a skin anomaly often associated with potentially significant morbidity and a cleft palate. Perioperative guidelines to successfully manage the cleft palate closure in these patients are presented.

Refinements in abdominoplasty.

When performing traditional abdominoplasty, three fundamental defects of the abdominal wall must always be addressed by the plastic surgeon. They include redundant skin, excess fat, and musculofascial laxity. Plastic surgeons have found that this procedure consists of dermolipectomy and rectus plication, extremely effective in restoring the abdomen to its youthful shape in the vast majority of patients.