Burns commonly occur in children and their first aid remains inadequate despite burn prevention programmes. While scald injuries predominate, contact and flame burns remain common. Although typically less severe injuries overall than those in adults, hypertrophic scarring complicating both the burn wound and even donor sites occur more frequently in children. The heterogeneous nature of burn wounds, coupled with the difficulties associated with the early clinical assessment of burn depth, has stimulated the application of novel technologies to predict burn wound outcome. This review explores current best practice in the management of paediatric burns, with a focus on prevention, optimal first aid, resuscitation, burn wound prediction and wound management strategies.
In conclusion, one of the most gratifying aspects of surgical practice, for the surgeon and patient alike, is the relief of pain. The challenge for surgeons is providing care for patients with chronic pain, and those at high risk of developing chronic pain, and performing pain-relieving procedures with limited evidence. The best way forward will be through improving pain education of surgeons, performing studies to establish the efficacy of the pain-relieving procedures we perform and maintaining transparency in our dealings with industry. If we do not accept this responsibility, others will make these decisions for us. Surgeons should be leaders in this process.
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