MUSC Children's Hospital - Pediatric Burn Team offers comprehensive care

We're all about children!

MUSC Children's Hospital Pediatric Burn Team offers comprehensive care
Fall 2002

The MUSC Children's Hospital Pediatric Burn Team combines pediatric surgery and pediatric burn care, an approach that gives specialized age-specific care in serving the needs of its young patients. "The care we give our patients focuses on the child's quality of life during and after hospitalization and outpatient care," said Jill Evans, RN, MSN, who coordinates the program.

As the state's center for pediatric burns, the MUSC Pediatric Burn Team has treated more than 350 hospitalized children over the past five years and provides more than 400 outpatient visits per year in a facility that has been named as one of the top 10 children's hospitals in the country by Child magazine. The burn team also is active in burn research projects, including clinical work on the use of temporary skin substitutes.

The treatment of children with burns requires input from a number of health care disciplines. Each child is cared for by up to four attending physicians, a burn nurse specialist, burn care technician, child life therapist, pharmacist, nutritionist, occupational and physical therapists and social workers. Additional specialists are available to meet the specific needs of each child, including critical care and psychiatric services.

While the burn team manages the spectrum of burns from minor to severe, approximately 80 percent of cases seen by the MUSC Children's Hospital Burn Team are burns of less than 10 percent total body surface area.

"Children with minor burns benefit by referral to a pediatric burn team for the management of scar tissue and the functional outcome after the burn," said Edward P. Tagge, MD, head of the MUSC Division of Pediatric Surgery. "Frequently, this is the more difficult part of burn care," he said. "Early recognition and treatment, including skin grafting, of full-thickness burns decreases the risk of complications such as infection, scarring and contractures."

For more severe burns, the role of temporary skin substitutes and cultured skin in the treatment of pediatric burns has significantly reduced the length of hospitalization, according to MUSC pediatric surgeon William Adamson, MD, medical director of the Children's Pediatric Burn Team. "Instead of the patient having to endure two to three dressing changes daily, biosynthetic dressings and cultured skin grafts can remain in place during the healing process," he said. "This means the child can go home sooner."

"Reduced hospital stays have a significant impact on the emotional well-being of the child, as well as the whole family," said Evans. Advances in wound healing technology now allow the team to offer intensive outpatient services, including wound care and therapy. The Pediatric Burn Clinic meets weekly, but with day treatment and pediatric ER options, pediatric burn patients can be seen for initial evaluation and care shortly following the time of injury or when it is deemed necessary by the referring physician.

For those with massive burn wounds, cultured skin substitutes allow for faster healing, and better protection against infections and other complications. "Early excision and grafting of devitalized tissue eliminates the major source of infection," Dr. Adamson said. For example, cultured skin grafts provide an alternative to skin grafting in cases where not enough unburned tissue is available for use as a donor site. The cultured skin grafts are made from the patient's skin cells, in combination with a medical fabric that dissolves after grafting to the wound.

Skin replacement products provide temporary covering for mid-dermal to more severe burns that require debridement and are likely to heal without surgical intervention. "These advances have made a profound difference in lives of burn victims," Dr. Adamson said.