Klein GL, Herndon DN: Burns. Pediatr Rev 2004;25(12):411-416.
The prognosis for surviving a serious, large burn injury is steadily improving with better diagnosis and management. This article defines burns, reviews the epidemiology and pathogenesis of burns (including acute changes, hypermetabolism, systemic inflammatory response syndrome and inhalation injury), the diagnosis, management and initial treatment of extensive burns, and prognosis. Many children experience first-degree burns from too much exposure to sunlight. These burns are usually painful to touch but heal within 1 week. Second- and third-degree burns result from hot fluids, hot objects, flames, high-voltage electricity, chemical agents, and various environmental situations. Children under 4 years of age who are burned on less than 50% of their total body surface area account for 19% of admissions to burn units, with a 12.5% death rate. The increased survival rate requires follow-up management of physical and emotional rehabilitation, reconstructive surgery, growth hormone to treat the hypermetabolic state, and reintegration of the child back into the school and community.