Pediatric Education and Research

Low level laser therapy (LLLT) has a role in wound bed preparation, wound healing process, joint stiffness, nerve regeneration, antimicrobial action and prevention of postburn scarring. Superficial burns are usually managed by healing by secondary intention. Deeper burns need early excision or debridement followed by cover by either skin graft or flap. Regenerative technology like low level laser therapy (LLLT) helps in healing of superficial burns. Further, Low Level Laser Therapy (LLLT) helps in controlling infection & promoting healthy granulation so that burn wound could be covered with skin graft or flap. After wound healing LLLT helps in prevention of hypertrophic or abnormal scarring. In this study, we studied the role of LLLT in management of pediatric thermal burns.

Multidisciplinary team has effectively adapted advanced reconstructive techniques merged with regenerative medicine modalities to improve outcomes. These treatments combine traditional reconstruction measures with regenerative medicine applications and has been termed ‘hybrid reconstructions’. The hybrid reconstruction model aids in maximizing the function while minimizing the disability and morbidity associated with traditional reconstruction.

Injuries remain the leading cause of pediatric mortality, and burns are the fourth most common mechanism of injury, Younger children more commonly present with scald burns; whereas, flame burns are seen more often in adolescents.1 We had a case of 25 percent pediatric scald injury for whom we had used various novel regenerative methods and we would like to share our experience of the same.

The term reactive arthritis was first introduced in 1969 as to describe a sequel to an old infection, usually being genitourinary or GI infection. This condition has a diverse clinical manifestations. Initially it was know as Reiter's disease or Fiessinger Leroy disease. It is a member of spondyloarthritis family. HLA-B27 is a known predisposing genetic factor and is triggered by systemic infection. CREG-B7 group of antigens are found in B27 negative patients and these antigens are cross reactive to B27. Long term follow up is needed in children to determine if more number of children develop recurrent arthritis or any other disease like psoriatic arthritis, ankylosing spondylitis etc. cytokines like TNF alpha and interferon secrete T helper cells which help in eliminating the bacteria. NSAIDs, corticosteroids and antibiotics play a role in mainstay treatment. Reactive arthritis is characterized by both articular and extraarticular symptoms. Extra-articular manifestations include genitourinary symptoms, ocular symptoms, skin manifestations and cardiac manifestations. The diagnosis of this conditions is mostly clinical. Eliminating the infectious agent is the mainstay of the treatment followed by NSAIDs, corticosteroids and DMARDs in severe cases not responding to primary treatment is important.

Plaster of Paris has traditionally been the preferred material for splints and Casts. The ability to properly apply casts and splints is a technical skill easily mastered with practice and an understanding of basic principles. Once the need for immobilization has been determined, the physician must decide whether to apply a splint or a cast. Splinting involves subsequent application of a non-circumferential support held in place by an elastic bandage. Casting involves circumferential application of plaster or fiberglass. This review article gives an overview of application of Plaster of Paris, Splints, Casts in Plastic Surgery.