In the 20-plus years that I have run the burn unit, I have acquired both by necessity and default, an expertise in the management of complex skin and soft tissue injuries. As a pediatric surgeon, you can use this opportunity based on your understanding of wound care generated from the care of hundreds of children with burns as a platform to guide the support and care of other patients with complex wounds.
Components of this care, in addition to wound management, include:
- familiarity with nutrition and metabolic support
- critical care applications including
- control of sepsis
- hemodynamic monitoring
- respiratory support
- integration of psycho-social services
- understanding of the importance of rehabilitation
There is also an opportunity for collaborative practice in the care of these patients, including working with intensivists, plastic surgeons, dermatologists, interventional radiologists, other pediatricians and nurses.
The diseases that fit into this category are:
- purpura fulminans, which is associated with meningococcal sepsis
- Stevens-Johnson syndrome or Toxic Epidermal Necrolysis
- hydradenitis suppurativa
- traumatic avulsions and abrasions
- lymphocutaneous malformations
- intravenous complications, which are one of the most common acquired maloccurences in the hospital, especially in the NICU