Annals of Plastic Surgery and Reconstructive Microsurgery no. 3/2005

Burned hand in children - acute treatment

C.Serbanescu, D.Enescu, S.Giuvelea, R. Alexandru, R. Bradanu, G. Constantinescu
Plastic Surgery Reconstructive Microsurgery Department
Clinical Emergency Hospital for children "Grigore Alexandrescu"

This paper represents the experience of the Plastic Surgery Unit, "Grigore Alexandrescu" Children Emergency Hospital in the treatment of the burn injuries that involve the hand as a sole localisation or in the context of extensive life-threatening burns and it results from a count of 500 cases per year.

The etiology of pediatric hand burns includes, in the order of frequency, scalds, contact burns, flame burns and electrocutions (low voltage). The treatment of the burned hand represents a surgical, functional priority (especially in the case of children) in order to promote a normal psychosomatic development and social reinsertion.

The basic therapy principles are accurately stated: viable tissue preservation, prevention of microvascular deterioration and infection (debriding, antibacterial topics), edema reduction (positioning, early escarotomy), rapid coverage (early excision of full-thickness burns followed by grafting), scars prevention (positioning, pressure garments, splinting), early functional rehabilitation and scar correction.

C.Serbanescu. D.Enescu. S.Giuvelea. R. Alexandra. R. Bratial7Ll. G. Constantinescu
Clinica de Chirurgie Plastica Microchirurgie Reconstructiva
Spitalul Clinic de Urgenta pentru Copii "Grigore Alexandrescu

Aceasta prezentare arata experienta clinicii de Chirurgie Phistica Microchirurgie Reconstructiva a Spitalului Clinic de Urgenta pentru Copii "Grigore Alexandreseu in tratamentul leziunilor de arsura cc implica mana ca localizare unica sau in contextul arsurilor extensive grave si rezultatele a peste 500 de astfel de cazuri tratate anual.

Etiologia arsurilor mainii la copii include, in ordinea frecventei, lichid fierbinte, arsuri prin contact, arsuri prin llacara si electrocutii (voltaj scazut). Tratainentul mainii arse reprezinta o prioritate funetionala pentru tratament chirurgical pentru o dezvoltare normala psihosomatica si reinsertie sociala. Principiile terapeutice de baza sunt bine exprimate: pastrarea tesutului vzabil. prevenirea deteriorarii microvasculare si a infectiei (debridare, topice antibacteriene). reducerea edemului (pozitionare, excizie precoce). acoperire rapida (excizie rapida a arsurilor toata grosimea urmata de grefare). profilaxia sechelelor (pozitionare, presoterapie, irnobilizare). reabilitare functionala precoce si corectie cicatriceala.