The Journal of burn care & rehabilitation
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Burn injuries can have a profound effect on the personality development and emotional stability of children, particularly those children who had preexisting pathologic conditions at the time of injury. Integration of an altered sense of self and reentry into the social arena are two challenges that children with burn injuries must face. Creative psychosocial services are of critical importance in providing support to children as they meet these challenges. School reentry programs and burn camps are presented as two services that are currently provided to facilitate the adaptation and reentry process for these children.
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Clinical experience assumes major importance as the source of data on cultured epidermal autograft (CEA), since a large controlled study is probably not forthcoming. Among the general questions to be answered are: Which patients are candidates for grafting with CEA? Do selection criteria specify size of total body surface area burn or age? Is CEA more suitable for certain body areas than others? Does CEA close the wound as quickly, as well, and as safely as other available methods of coverage? Fresh or frozen allograft, the gold standard, is presumed to be safe, but the current concern about transmission of viral diseases raises doubts. Presumably, CEA would be safe. ⋯ Whether CEA saves lives is probably unanswerable, but as a skin cover it may reduce incidence of burn wound sepsis. Perhaps in the future, a combination of cultured epidermal cells and a type of permanent dermis will produce a cover that is genuine skin. Today we have only materials that are parts of skin.