Laparoscopic repair of penetrating splenic injury.

Historically, all splenic injuries were treated with splenectomy. In recent decades, however, there has been a trend toward splenic conservation methods in an attempt to preserve immunologic functions. Although cases of splenic conservation in the setting of penetrating injuries exist in the literature, this method of management is more commonly attempted in blunt traumas. When presented with penetrating splenic trauma, surgeons generally still proceed directly to exploratory laparotomy with splenectomy. Splenic injuries are rarely repaired with splenorrhaphy due to surgeon inexperience and concern for reoperation. We conclude from this case that when presented with a penetrating splenic trauma in a hemodynamically stable patient, management by laparoscopic exploration with splenorrhaphy can be safe and effective.

Postburn sequelae in the pediatric patient: clinical presentations and treatment options.

Each year, more and more children acquire burns that require serious medical attention. A vast number of these burns lead to permanent disfigurement and long-term disability. As health care providers, focus should not only be on the immediate treatment, but also on the long-term outcome of these burns and the required rehabilitation that these burn patients must go through. During the rehabilitation phase of the burn, focus should be placed on how to prevent and treat several sequelae that include hypertrophic scarring, keloids, contractures, heterotopic ossification, leukoderma, and pruritus. One must also use a multidisciplinary team approach to help reintegrate the patient back into their environment.