[Surgical treatment of burns : Special aspects of pediatric burns]. / Chirurgische Behandlung von Verbrennungen : Besonderheiten bei Kindern.

BACKGROUND: Treatment of pediatric burn patients is very important because of the sheer frequency of burn wounds and the possible long-term ramifications. Extensive burns need special care and are treated in specialized burn centers. OBJECTIVES: The goal of this work is to present current standards in burn therapy and important innovations in the treatment of burns in children so that the common and small area burn wounds and scalds in pediatric patients in day-to-day dermatological practice can be adequately treated. MATERIALS AND METHODS: Analysis of current literature, discussion of reviews, incorporation of current guidelines. RESULTS: Burns in pediatric patients are common. Improvement of survival can be achieved by treatment in burn centers. The assessment of burn depth and area is an important factor for proper treatment. We give an overview for outpatient treatment of partial thickness burns. New methods may result in better long-term outcome. CONCLUSIONS: Adequate treatment of burn injuries considering current literature and guidelines improves patient outcome. Rational implementation of new methods is recommended.

[Merkel Cell Carcinoma - A Rare Entity with Specific Reconstructive Challenges]. / Merkelzellkarzinome - eine seltene Entität mit spezifischen rekonstruktiven Herausforderungen.

BACKGROUND: Merkel cell carcinoma is a rare tumor, which is associated with poor prognosis. It has been shown that radical local excision and radiotherapy are essentiell for curative therapy. To avoid compromise in tumor treatment, plastic surgery is often needed. Furthermore, using complex reconstruction methods, like free flap transplantation, has proven to be effective to avoid long and complicated clinical courses. PATIENTS: Between 2003 and 2016 15 patients with Merkel cell carcinoma were treated in our department. In 2 cases additional resection had to take place before reconstruction was performed. In most cases, a safety margin of 2 cm was chosen. Complete excision could be achieved in 13 patients. We used different methods of reconstruction such as primary suturing, skin transplantations, local, pedicled or free flaps. RESULTS: In all patients defects could be reconstructed with good results, which proved to be stable even under postoperative radiation therapy. CONCLUSION: Given the modern techniques of plastic surgery the extent of local excision should not be should be chosen as radical as possible and necessary. It has been proven that interdisciplinary treatment of patients with Merkel cell carcinoma increases the chances for curative therapy while providing safe methods for reconstruction despite radiotherapy, extensive tumors or difficult localization.

[School and child health]. / Die Schule und die Gesundheit des Kindes.

A roundtable discussion involving 2 educators and 4 pediatricians with widely varying experience sounded out the negative (pathogenic) and positive (healthy) influences to which a child is exposed in school and which decisively shape his/her physical, mental and psychic development. Concrete case reports and a systematic compilation of harmful factors show that this institution poses major threats to children's health of which pediatricians should be aware. An important cause of childhood suffering is the discrepancy between the uniform and inflexible institutional structures and the variability of children's needs conditioned by biology and social origin. Between ideal visions and the consequent school structures on the one hand, and social reality on the other hand, there are notable contradictions which must be recognized, lived with and--if possible--resolved by reforms. If he believes in the reformability of school, the pediatrician can make essential contribution to promoting health during school age.