Timing of burn therapy in the pediatric patient.

The physician embarking on the long-term management of burned children must have a very strong and honest relationship with the patient and family or guardians and must use all available resources, including physical and occupational therapists, social workers, and others, over the course of the effort. There is rarely an end-point in the rehabilitation of a burned child, and the surgeon must be aware of the effects of growth, have state-of-the-art knowledge of reconstructive techniques, and ideally have adequate experience to predict the effects of therapy over many years. This experience often can be gained only from senior surgical colleagues who have the advantage of experience following years of observing wounds heal and operations mature. The timing of many facets of pediatric burn care is, in many ways, abstract and based on intense clinical acumen and physical examination. However, it is imperative that the physician develop a treatment timetable based on the principles of contemporary burn care.